Diagnostic and Prognostic Value of CMR T1-Mapping in Patients With Heart Failure and Preserved Ejection Fraction.
Heart failure with preserved ejection fraction (HFpEF) presents a major challenge in modern cardiology. Although this syndrome is of increasing prevalence and is associated with unfavorable outcomes, treatment trials have failed to establish effective therapies. Currently, solutions to this dilemma are being investigated, including categorizing and characterizing patients more diversely to individualize treatment. In this regard, new imaging techniques might provide important information. Diastolic dysfunction is a diagnostic and pathophysiological cornerstone in HFpEF and is believed to be caused by systemic inflammation with the development of interstitial myocardial fibrosis and myocardial stiffening. Cardiac magnetic resonance (CMR) T1-mapping is a novel tool, which allows noninvasive quantification of the extracellular space and diffuse myocardial fibrosis. This review provides an overview of the potential of myocardial tissue characterization with CMR T1mapping in HFpEF patients, outlining its diagnostic and prognostic implications and discussing future directions. We conclude that CMR T1mapping is potentially an effective tool for patient characterization in large-scale epidemiological, diagnostic, and therapeutic HFpEF trials beyond traditional imaging parameters.
Department of Internal Medicine/Cardiology, Heart Center, University of Leipzig, Leipzig, Germany.
Karl-Philipp
KP
Rommel
Department of Radiology, University of Leipzig, Heart Center, Leipzig, Germany.
Christian
C
Lücke
Department of Internal Medicine/Cardiology, Heart Center, University of Leipzig, Leipzig, Germany. Electronic address: Philipp.Lurz@gmx.de.
Philipp
P
Lurz
D005110:Extracellular Space / Q000000981:diagnostic imaging*; D005355:Fibrosis; D006321:Heart / Q000000981:diagnostic imaging*; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology; D054144:Heart Failure, Diastolic / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D009206:Myocardium / Q000473:pathology*; D011379:Prognosis; D013318:Stroke Volume
Cardiac magnetic resonance; Diastolic dysfunction; Disfunción diastólica; Heart failure with preserved ejection fraction; Insuficiencia cardiaca con fracción de eyección conservada; Mapeo T(1); Resonancia magnética cardiaca; T(1) mapping