title: Increased native T1-values at the interventricular insertion regions in precapillary pulmonary hypertension.
abstract: Cardiac magnetic resonance imaging of the pressure overloaded right ventricle (RV) of precapillary pulmonary hypertension (PH) patients, exhibits late gadolinium enhancement at the interventricular insertion regions, a phenomenon which has been linked to focal fibrosis. Native T1-mapping is an alternative technique to characterize myocardium and has the advantage of not requiring the use of contrast agents. The aim of this study was to characterize the myocardium of idiopathic pulmonary arterial hypertension (IPAH), systemic scleroderma related PH (PAH-Ssc) and chronic thromboembolic PH (CTEPH) patients using native T1-mapping and to see whether native T1-values were related to disease severity. Furthermore, we compared native T1-values between the different precapillary PH categories. Native T1-mapping was performed in 46 IPAH, 14 PAH-SSc and 10 CTEPH patients and 10 control subjects. Native T1-values were assessed using regions of interest at the RV and LV free wall, interventricular septum and interventricular insertion regions. In PH patients, native T1-values of the interventricular insertion regions were significantly higher than the native T1-values of the RV free wall, LV free wall and interventricular septum. Native T1-values at the insertion regions were significantly related to disease severity. Native T1-values were not different between IPAH, PAH-Ssc and CTEPH patients. Native T1-values of the interventricular insertion regions are significantly increased in precapillary PH and are related to disease severity. Native T1-mapping can be developed as an alternative technique for the characterization of the interventricular insertion regions and has the advantage of not requiring the use of contrast agents.
authors.affiliation: Department of Pulmonary Medicine, VU University Medical Center, Amsterdam, The Netherlands. o.spruijt@vumc.nl.
authors.forename: Onno A
authors.initials: OA
authors.lastname: Spruijt
authors.affiliation: Department of Pulmonary Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Loek
authors.initials: L
authors.lastname: Vissers
authors.affiliation: Department of Pulmonary Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Harm-Jan
authors.initials: HJ
authors.lastname: Bogaard
authors.affiliation: Department of Physics and Medical Technology, ICaR-VU, VU University Medical Center, de Boelelaan 1117, PK-1Y138, 1081HV, Amsterdam, The Netherlands.
authors.forename: Mark B M
authors.initials: MB
authors.lastname: Hofman
authors.affiliation: Department of Pulmonary Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Anton
authors.initials: A
authors.lastname: Vonk-Noordegraaf
authors.affiliation: Department of Physics and Medical Technology, ICaR-VU, VU University Medical Center, de Boelelaan 1117, PK-1Y138, 1081HV, Amsterdam, The Netherlands. jt.marcus@vumc.nl.
authors.forename: J Tim
authors.initials: JT
authors.lastname: Marcus
mesh_terms: D000328:Adult; D000368:Aged; D062186:Arterial Pressure; D002908:Chronic Disease; D065627:Familial Primary Pulmonary Hypertension / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005355:Fibrosis; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000150:complications; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000150:complications; D012720:Severity of Illness Index; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016278:Ventricular Function, Right
keywords: Myocardium; Non-contrast T1; Pulmonary hypertension; T1-mapping