PMID- 22974802
OWN - NLM
STAT- MEDLINE
DCOM- 20130205
LR  - 20240213
IS  - 1876-7591 (Electronic)
IS  - 1936-878X (Print)
IS  - 1876-7591 (Linking)
VI  - 5
IP  - 9
DP  - 2012 Sep
TI  - Quantification of extracellular matrix expansion by CMR in infiltrative heart 
      disease.
PG  - 897-907
LID - 10.1016/j.jcmg.2012.04.006 [doi]
AB  - OBJECTIVES: The aim of this study was to perform direct quantification of 
      myocardial extracellular volume fraction (ECF) with T1-weighted cardiac magnetic 
      resonance (CMR) imaging in patients suspected to have infiltrative heart disease. 
      BACKGROUND: Infiltrative heart disease refers to accumulation of abnormal 
      substances within the myocardium. Qualitative assessment of late gadolinium 
      enhancement (LGE) remains the most commonly used method for CMR evaluation of 
      patients suspected with myocardial infiltration. This technique is widely 
      available and can be performed in a reproducible and standardized manner. 
      However, the degree of extracellular matrix expansion due to myocardial 
      infiltration in the intercellular space has, to date, not been amenable to 
      noninvasive quantification with LGE. METHODS: We performed 3-T CMR in 38 patients 
      (mean age 68 +/- 15 years) who were referred for assessment of infiltrative heart 
      disease and also in 9 healthy volunteers as control subjects. The T1 
      quantification by Look-Locker gradient-echo before and after contrast determined 
      segmental myocardial partition coefficients. The ECF was obtained by referencing 
      the tissue partition coefficient for gadolinium to the plasma volume fraction in 
      blood, derived from serum hematocrit. Cine CMR and LGE imaging in matching 
      locations were also performed. RESULTS: Seventeen patients (45%) had cardiac 
      amyloidosis (CA) (biopsy-confirmed or clinically highly probable), 20 (53%) had a 
      non-amyloid cardiomyopathy, and 1 had lysosomal storage disease. Median global 
      ECF was substantially higher in CA patients (0.49) compared with non-amyloid 
      cardiomyopathy patients (0.33, p < 0.0001) and volunteers (0.24, p = 0.0001). The 
      ECF strongly correlated with visually assessed segmental LGE (r = 0.80, p < 
      0.0001) and LV mass index (r = 0.69, p < 0.0001), reflecting severity of 
      myocardial infiltration. In patients with CA, ECF was highest in segments with 
      LGE, although it remained elevated in segments without qualitative LGE. 
      CONCLUSIONS: The CMR ECF quantification identified substantial expansion of the 
      interstitial space in patients with CA compared with volunteers. Further studies 
      using this technique for diagnosis and assessment of the severity of myocardial 
      infiltration are warranted.
CI  - Copyright (c) 2012 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Mongeon, Francois-Pierre
AU  - Mongeon FP
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Harvard Medical School, Boston, Massachusetts 02115, USA.
FAU - Jerosch-Herold, Michael
AU  - Jerosch-Herold M
FAU - Coelho-Filho, Otavio Rizzi
AU  - Coelho-Filho OR
FAU - Blankstein, Ron
AU  - Blankstein R
FAU - Falk, Rodney H
AU  - Falk RH
FAU - Kwong, Raymond Y
AU  - Kwong RY
LA  - eng
GR  - R01 HL090634/HL/NHLBI NIH HHS/United States
GR  - R01 HL091157/HL/NHLBI NIH HHS/United States
GR  - R01HL091157/HL/NHLBI NIH HHS/United States
GR  - R01HL090634-01A1/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
CIN - JACC Cardiovasc Imaging. 2012 Sep;5(9):908-10. PMID: 22974803
MH  - Aged
MH  - Aged, 80 and over
MH  - Amyloidosis/pathology
MH  - Biopsy
MH  - Cardiomyopathies/*pathology
MH  - Chi-Square Distribution
MH  - Contrast Media
MH  - Cross-Sectional Studies
MH  - Extracellular Matrix/*pathology
MH  - Gadolinium DTPA
MH  - Humans
MH  - Linear Models
MH  - Lysosomal Storage Diseases/pathology
MH  - *Magnetic Resonance Imaging, Cine
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Severity of Illness Index
PMC - PMC3954504
MID - NIHMS561026
EDAT- 2012/09/15 06:00
MHDA- 2013/02/06 06:00
PMCR- 2014/03/14
CRDT- 2012/09/15 06:00
PHST- 2011/07/06 00:00 [received]
PHST- 2012/02/23 00:00 [revised]
PHST- 2012/04/09 00:00 [accepted]
PHST- 2012/09/15 06:00 [entrez]
PHST- 2012/09/15 06:00 [pubmed]
PHST- 2013/02/06 06:00 [medline]
PHST- 2014/03/14 00:00 [pmc-release]
AID - S1936-878X(12)00532-3 [pii]
AID - 10.1016/j.jcmg.2012.04.006 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2012 Sep;5(9):897-907. doi: 10.1016/j.jcmg.2012.04.006.