PMID- 25246502 OWN - NLM STAT- MEDLINE DCOM- 20151112 LR - 20220410 IS - 2047-2412 (Electronic) IS - 2047-2404 (Linking) VI - 16 IP - 2 DP - 2015 Feb TI - T1 mapping in dilated cardiomyopathy with cardiac magnetic resonance: quantification of diffuse myocardial fibrosis and comparison with endomyocardial biopsy. PG - 210-6 LID - 10.1093/ehjci/jeu183 [doi] AB - AIM: The aim of this study was to determine the value of extracellular volume fraction (ECV) for the non-invasive assessment of diffuse myocardial fibrosis (MF) in different stages of systolic left ventricular (LV) dysfunction in dilated cardiomyopathy (DCM) in comparison with endomyocardial biopsy. BACKGROUND: Non-invasive ECV assessment using cardiovascular magnetic resonance (CMR) T1 mapping reflects diffuse MF in patients with severe DCM, but earlier stages of DCM with mild LV functional impairment have not been investigated yet. METHODS: Forty-five subjects with mild functional impairment and LV dilation ['early DCM', ejection fraction (EF) 45-55%], 29 with LV dysfunction and volume dilatation ('DCM', EF <45%) and 56 healthy volunteers (controls) underwent standard CMR imaging, late gadolinium enhancement (LGE) and T1 mapping for the calculation of ECV. The collagen volume fraction (CVF) was quantified histologically from endomyocardial biopsies of 24 DCM patients out of the study cohort. RESULTS: The ECV between 'early DCM' (25 +/- 4%), 'DCM' (27 +/- 4%), and controls (23 +/- 3; P < 0.05 for all) differed significantly. There was a weak inverse correlation between ECV and EF (r = -0.35; P < 0.01). A strong correlation between ECV and CVF could be detected (r = 0.85; P = 0.01). The cut-off value for ECV to differentiate between healthy myocardium and DCM was 26% (specificity 91.1%, sensitivity 62.1%, area under the curve 0.8, P < 0.0001). ECV is already elevated at early stages of functional impairment, whereby an overlap between early DCM and controls is present. But 31% of the early DCM patients had an ECV fraction above the mean +/-2 SD ECV of controls. CONCLUSIONS: ECV measurement with CMR reflects myocardial collagen content in DCM. Therefore, CMR-based assessment of ECV may have the potential to serve as a non-invasive tool for the quantification of diffuse MF in order to monitor therapy response and aid risk stratification in different stages of DCM. CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author 2014. For permissions please email: journals.permissions@oup.com. FAU - aus dem Siepen, Fabian AU - aus dem Siepen F AD - Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany. FAU - Buss, Sebastian J AU - Buss SJ AD - Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany sebastian.buss@med.uni-heidelberg.de. FAU - Messroghli, Daniel AU - Messroghli D AD - Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Institute Berlin, Augustenburger Platz 1, Berlin 13353, Germany. FAU - Andre, Florian AU - Andre F AD - Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany. FAU - Lossnitzer, Dirk AU - Lossnitzer D AD - Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany. FAU - Seitz, Sebastian AU - Seitz S AD - Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany. FAU - Keller, Marius AU - Keller M AD - Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany. FAU - Schnabel, Philipp A AU - Schnabel PA AD - Institute for Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, Heidelberg 69120, Germany. FAU - Giannitsis, Evangelos AU - Giannitsis E AD - Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany. FAU - Korosoglou, Grigorios AU - Korosoglou G AD - Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany. FAU - Katus, Hugo A AU - Katus HA AD - Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany. FAU - Steen, Henning AU - Steen H AD - Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany. LA - eng PT - Comparative Study PT - Journal Article DEP - 20140922 PL - England TA - Eur Heart J Cardiovasc Imaging JT - European heart journal. Cardiovascular Imaging JID - 101573788 RN - 0 (Contrast Media) RN - K2I13DR72L (Gadolinium DTPA) SB - IM MH - Biopsy MH - Cardiac-Gated Imaging Techniques MH - Cardiomyopathy, Dilated/*pathology MH - Case-Control Studies MH - Contrast Media MH - Coronary Angiography MH - Echocardiography MH - Female MH - Fibrosis MH - Gadolinium DTPA MH - Humans MH - Image Interpretation, Computer-Assisted MH - Magnetic Resonance Imaging/*methods MH - Male MH - Middle Aged MH - Prospective Studies MH - Reproducibility of Results MH - Retrospective Studies MH - Severity of Illness Index OTO - NOTNLM OT - Cardiovascular magnetic resonance imaging OT - DCM OT - ECV OT - T1-mapping EDAT- 2014/09/24 06:00 MHDA- 2015/11/13 06:00 CRDT- 2014/09/24 06:00 PHST- 2014/09/24 06:00 [entrez] PHST- 2014/09/24 06:00 [pubmed] PHST- 2015/11/13 06:00 [medline] AID - jeu183 [pii] AID - 10.1093/ehjci/jeu183 [doi] PST - ppublish SO - Eur Heart J Cardiovasc Imaging. 2015 Feb;16(2):210-6. doi: 10.1093/ehjci/jeu183. Epub 2014 Sep 22.