Native myocardial T1 mapping in pulmonary hypertension: correlations with cardiac function and hemodynamics.
OBJECTIVE
To analyze alterations in left ventricular (LV) myocardial T1 times in patients with pulmonary hypertension (PH) and to investigate their associations with ventricular function, mass, geometry and hemodynamics.


METHODS
Fifty-eight patients with suspected PH underwent right heart catheterization (RHC) and 3T cardiac magnetic resonance imaging. Ventricular function, geometry and mass were derived from cine real-time short-axis images. Myocardial T1 maps were acquired by a prototype modified Look-Locker inversion-recovery sequence in short-axis orientations. LV global, segmental and ventricular insertion point (VIP) T1 times were evaluated manually and corrected for blood T1.


RESULTS
Septal, lateral, global and VIP T1 times were significantly higher in PH than in non-PH subjects (septal, 1249 ± 58 ms vs. 1186 ± 33 ms, p < 0.0001; lateral, 1190 ± 45 ms vs. 1150 ± 33 ms, p = 0.0003; global, 1220 ± 52 ms vs. 1171 ± 29 ms, p < 0.0001; VIP, 1298 ± 78 ms vs. 1193 ± 31 ms, p < 0.0001). In PH, LV eccentricity index was the strongest linear predictor of VIP T1 (r = 0.72). Septal, lateral and global T1 showed strong correlations with VIP T1 (r = 0.81, r = 0.59 and r = 0.75, respectively).


CONCLUSIONS
In patients with PH, T1 times in VIPs and in the entire LV myocardium are elevated. LV eccentricity strongly correlates with VIP T1 time, which in turn is strongly associated with T1 time changes in the entire LV myocardium.


CONCLUSIONS
• Native T1 mapping detects left ventricular myocardial alterations in pulmonary hypertension • In pulmonary hypertension, native T1 times at ventricular insertion points are increased • These T1 times correlate strongly with left ventricular eccentricity • In pulmonary hypertension, global and segmental myocardial T1 times are increased • Global, segmental and ventricular insertion point T1 times are strongly correlated.
Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9/P, A-8036, Graz, Austria. ursula.reiter@medunigraz.at.
Ursula
U
Reiter
Siemens Healthcare, Graz, Austria.
Gert
G
Reiter
Division of Pulmology, Department of Internal Medicine, Medical University of Graz, & LBI for Lung Vascular Research, Graz, Austria.
Gabor
G
Kovacs
Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9/P, A-8036, Graz, Austria.
Gabriel
G
Adelsmayr
Siemens Healthcare, Erlangen, Germany.
Andreas
A
Greiser
Division of Pulmology, Department of Internal Medicine, Medical University of Graz, & LBI for Lung Vascular Research, Graz, Austria.
Horst
H
Olschewski
Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9/P, A-8036, Graz, Austria.
Michael
M
Fuchsjäger
D006328:Cardiac Catheterization; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000503:physiopathology; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies
Cardiac function; Cardiac magnetic resonance imaging; Pulmonary hypertension; Right heart hemodynamics; T1 mapping