PMID- 25410203
OWN - NLM
STAT- MEDLINE
DCOM- 20150330
LR  - 20240117
IS  - 1532-429X (Electronic)
IS  - 1097-6647 (Print)
IS  - 1097-6647 (Linking)
VI  - 16
IP  - 1
DP  - 2014 Nov 20
TI  - Adenosine stress native T1 mapping in severe aortic stenosis: evidence for a role 
      of the intravascular compartment on myocardial T1 values.
PG  - 92
LID - 10.1186/s12968-014-0092-y [doi]
LID - 92
AB  - BACKGROUND: Myocardial T1 relaxation times have been reported to be markedly 
      abnormal in diverse myocardial pathologies, ascribed to interstitial changes, 
      evaluated by T1 mapping and calculation of extracellular volume (ECV). T1 mapping 
      is sensitive to myocardial water content of both intra- and extracellular in 
      origin, but the effect of intravascular compartment changes on T1 has been 
      largely neglected. We aimed to assess the role of intravascular compartment on 
      native (pre-contrast) T1 values by studying the effect of adenosine-induced 
      vasodilatation in patients with severe aortic stenosis (AS) before and after 
      aortic valve replacement (AVR). METHODS: 42 subjects (26 patients with severe AS 
      without obstructive coronary artery disease and 16 controls) underwent 
      cardiovascular magnetic resonance at 3 T for native T1-mapping (ShMOLLI), 
      first-pass perfusion (myocardial perfusion reserve index-MPRI) at rest and during 
      adenosine stress, and late gadolinium enhancement (LGE). RESULTS: AS patients had 
      increased resting myocardial T1 (1196+/-47 ms vs. 1168+/-27 ms, p=0.037), reduced 
      MPRI (0.92+/-0.31 vs. 1.74+/-0.32, p<0.001), and increased left ventricular mass 
      index (LVMI) and LGE volume compared to controls. During adenosine stress, T1 in 
      AS was similar to controls (1240+/-51 ms vs. 1238+/-54 ms, p=0.88), possibly 
      reflecting a similar level of maximal coronary vasodilatation in both groups. 
      Conversely, the T1 response to stress was blunted in AS (DeltaT1 3.7+/-2.7% vs. 
      6.0+/-4.2% in controls, p=0.013). Seven months after AVR (n=16) myocardial T1 and 
      response to adenosine stress recovered towards normal. Native T1 values 
      correlated with reduced MPRI, aortic valve area, and increased LVMI. CONCLUSIONS: 
      Our study suggests that native myocardial T1 values are not only influenced by 
      interstitial and intracellular water changes, but also by changes in the 
      intravascular compartment. Performing T1 mapping during or soon after vasodilator 
      stress may affect ECV measurements given that hyperemia alone appears to 
      substantially alter T1 values.
FAU - Mahmod, Masliza
AU  - Mahmod M
AD  - University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), 
      Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John 
      Radcliffe Hospital, Oxford OX3 9DU, UK. masliza.mahmod@cardiov.ox.ac.uk.
FAU - Piechnik, Stefan K
AU  - Piechnik SK
FAU - Levelt, Eylem
AU  - Levelt E
FAU - Ferreira, Vanessa M
AU  - Ferreira VM
FAU - Francis, Jane M
AU  - Francis JM
FAU - Lewis, Andrew
AU  - Lewis A
FAU - Pal, Nikhil
AU  - Pal N
FAU - Dass, Sairia
AU  - Dass S
FAU - Ashrafian, Houman
AU  - Ashrafian H
FAU - Neubauer, Stefan
AU  - Neubauer S
FAU - Karamitsos, Theodoros D
AU  - Karamitsos TD
LA  - eng
GR  - PG/08/101/26126/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20141120
PL  - England
TA  - J Cardiovasc Magn Reson
JT  - Journal of cardiovascular magnetic resonance : official journal of the Society 
      for Cardiovascular Magnetic Resonance
JID - 9815616
RN  - 0 (Contrast Media)
RN  - 0 (Vasodilator Agents)
RN  - 84F6U3J2R6 (gadodiamide)
RN  - K2I13DR72L (Gadolinium DTPA)
RN  - K72T3FS567 (Adenosine)
SB  - IM
MH  - *Adenosine
MH  - Aged
MH  - Aortic Valve/physiopathology/surgery
MH  - Aortic Valve Stenosis/*diagnosis/pathology/physiopathology/surgery
MH  - Case-Control Studies
MH  - Contrast Media
MH  - *Coronary Circulation
MH  - Female
MH  - Fibrosis
MH  - Gadolinium DTPA
MH  - Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - *Myocardial Contraction
MH  - Myocardial Perfusion Imaging/*methods
MH  - Myocardium/pathology
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - *Vasodilation
MH  - *Vasodilator Agents
MH  - *Ventricular Function, Left
PMC - PMC4237748
EDAT- 2014/11/21 06:00
MHDA- 2015/03/31 06:00
PMCR- 2014/11/20
CRDT- 2014/11/21 06:00
PHST- 2014/07/07 00:00 [received]
PHST- 2014/11/04 00:00 [accepted]
PHST- 2014/11/21 06:00 [entrez]
PHST- 2014/11/21 06:00 [pubmed]
PHST- 2015/03/31 06:00 [medline]
PHST- 2014/11/20 00:00 [pmc-release]
AID - S1097-6647(23)00159-X [pii]
AID - 92 [pii]
AID - 10.1186/s12968-014-0092-y [doi]
PST - epublish
SO  - J Cardiovasc Magn Reson. 2014 Nov 20;16(1):92. doi: 10.1186/s12968-014-0092-y.