title: Aortic stiffness and interstitial myocardial fibrosis by native T1 are independently associated with left ventricular remodeling in patients with dilated cardiomyopathy.
abstract: Increased aortic stiffness is related to increased ventricular stiffness and remodeling. Myocardial fibrosis is the pathophysiological hallmark of failing heart. We investigated the relationship between noninvasive imaging markers of myocardial fibrosis, native T1, and late gadolinium enhancement, respectively, and aortic stiffness in ventricular remodeling. Consecutive patients with known dilated cardiomyopathy (n=173) underwent assessment of cardiac volumes and function, T1 mapping, scar imaging, and pulse wave velocity, a measure of aortic stiffness. Asymptomatic healthy volunteers served as controls (n=47). Controls and patients showed an increase in pulse wave velocity with age, which was accelerated in the presence of cardiovascular disease. On the contrary, native T1 increased with age in patients, but not in controls. Pulse wave velocity was associated with native T1 in the presence of disease, but not in health. Native T1 showed a strong relationship with markers of structural and functional left ventricular remodeling and diastolic impairment. Ischemic and nonischemic pathophysiology of ventricular remodeling showed a similar slope of relationship between pulse wave velocity and native T1. However, in nonischemic patients, increase in pulse wave velocity was associated with greater increase in native T1. Aortic stiffness is related to age, and this process is accelerated in the presence of disease. On the contrary, increase in interstitial myocardial fibrosis is associated with age in the presence of disease. Patients with ischemic and nonischemic dilated cardiomyopathy have a similar relationship between native T1 and pulse wave velocity, which is stronger in the latter group.
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.). v.puntmann@kcl.ac.uk.
authors.forename: Valentina O
authors.initials: VO
authors.lastname: Puntmann
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: Eduardo
authors.initials: E
authors.lastname: Arroyo Ucar
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: Rocio
authors.initials: R
authors.lastname: Hinojar Baydes
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: Ning Binti
authors.initials: NB
authors.lastname: Ngah
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: Yen-Shu
authors.initials: YS
authors.lastname: Kuo
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: Darius
authors.initials: D
authors.lastname: Dabir
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: Alexandra
authors.initials: A
authors.lastname: Macmillan
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: Ciara
authors.initials: C
authors.lastname: Cummins
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: David M
authors.initials: DM
authors.lastname: Higgins
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: Nicholas
authors.initials: N
authors.lastname: Gaddum
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: Phil
authors.initials: P
authors.lastname: Chowienczyk
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: Sven
authors.initials: S
authors.lastname: Plein
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: Gerry
authors.initials: G
authors.lastname: Carr-White
authors.affiliation: From the Department of Cardiovascular Imaging, Division of Imaging Sciences and Biomedical Engineering (V.O.P., E.A.U., R.H.B., N.B.N., Y.-S.K., D.D., A.M., C.C., S.P., G.C.-W., E.N.), Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering (N.G.), and Cardiovascular Division (P.C.), King's College London, United Kingdom; Department of Radiology, University of Bonn, Germany (D.D.); Philips Healthcare, United Kingdom (D.M.H.); and University of Leeds, United Kingdom (S.P.).
authors.forename: Eike
authors.initials: E
authors.lastname: Nagel
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002311:Cardiomyopathy, Dilated / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005355:Fibrosis; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000473:pathology*; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D020257:Ventricular Remodeling
keywords: cardiomyopathy, dilated; endomyocardial fibrosis; vascular stiffness