Relationship between Myocardial Extracellular Space Expansion Estimated with Post-Contrast T1 Mapping MRI and Left Ventricular Remodeling and Neurohormonal Activation in Patients with Dilated Cardiomyopathy.
OBJECTIVE
Post-contrast T1 values are closely related to the degree of myocardial extracellular space expansion. We determined the relationship between post-contrast T1 values and left ventricular (LV) diastolic function, LV remodeling, and neurohormonal activation in patients with dilated cardiomyopathy (DCM).


METHODS
Fifty-nine patients with DCM (mean age, 55 ± 15 years; 41 males and 18 females) who underwent both 1.5T magnetic resonance imaging and echocardiography were enrolled. The post-contrast 10-minute T1 value was generated from inversion time scout images obtained using the Look-Locker inversion recovery sequence and a curve-fitting algorithm. The T1 sample volume was obtained from three interventricular septal points, and the mean T1 value was used for analysis. The N-Terminal pro-B-type natriuretic peptide (NT-proBNP) level was measured in 40 patients.


RESULTS
The mean LV ejection fraction was 24 ± 9% and the post-T1 value was 254.5 ± 46.4 ms. The post-contrast T1 value was significantly correlated with systolic longitudinal septal velocity (s'), peak late diastolic velocity of the mitral annulus (a'), the diastolic elastance index (Ed, [E/e']/stroke volume), LV mass/volume ratio, LV end-diastolic wall stress, and LV end-systolic wall stress. In a multivariate analysis without NT-proBNP, T1 values were independently correlated with Ed (β = -0.351, p = 0.016) and the LV mass/volume ratio (β = 0.495, p = 0.001). When NT-proBNP was used in the analysis, NT-proBNP was independently correlated with the T1 values (β = -0.339, p = 0.017).


CONCLUSIONS
Post-contrast T1 is closely related to LV remodeling, diastolic function, and neurohormonal activation in patients with DCM.
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 06273, Korea.
Ji Hyun
JH
Yoon
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 06273, Korea.
Jung Woo
JW
Son
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 06273, Korea.
Hyemoon
H
Chung
Department of Radiology, Yonsei University College of Medicine, Seoul 06273, Korea.
Chul Hwan
CH
Park
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 06273, Korea.
Young-Jin
YJ
Kim
Department of Radiology, Yonsei University College of Medicine, Seoul 06273, Korea.
Hyuk-Jae
HJ
Chang
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 06273, Korea.
Geu-Ru
GR
Hong
Department of Radiology, Yonsei University College of Medicine, Seoul 06273, Korea.
Tae Hoon
TH
Kim
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 06273, Korea.
Jong-Won
JW
Ha
Department of Radiology, Yonsei University College of Medicine, Seoul 06273, Korea.
Byoung Wook
BW
Choi
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 06273, Korea.
Se-Joong
SJ
Rim
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 06273, Korea.
Namsik
N
Chung
Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 06273, Korea.
Eui-Young
EY
Choi
D000328:Adult; D000368:Aged; D000465:Algorithms; D001794:Blood Pressure; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004452:Echocardiography; D005110:Extracellular Space / Q000000981:diagnostic imaging* / Q000502:physiology; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D010446:Peptide Fragments / Q000032:analysis; D011859:Radiography; D020257:Ventricular Remodeling
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
Diastolic function; Dilated cardiomyopathy; T1 mapping