PMID- 30089499
OWN - NLM
STAT- MEDLINE
DCOM- 20190314
LR  - 20240117
IS  - 1532-429X (Electronic)
IS  - 1097-6647 (Print)
IS  - 1097-6647 (Linking)
VI  - 20
IP  - 1
DP  - 2018 Aug 9
TI  - Extracellular volume fraction measurements derived from the longitudinal 
      relaxation of blood-based synthetic hematocrit may lead to clinical errors in 3 T 
      cardiovascular magnetic resonance.
PG  - 56
LID - 10.1186/s12968-018-0475-6 [doi]
LID - 56
AB  - BACKGROUND: The extracellular volume (ECV), derived from cardiovascular magnetic 
      resonance (CMR) T1 mapping, is a biomarker of the extracellular space in the 
      myocardium. The hematocrit (HCT), measured from venipuncture, is required for ECV 
      measurement. We test the clinic values of synthetic ECV, which is derived from 
      the longitudinal relaxation of blood-based (T1(blood)) synthetic hematocrit in 
      3 T CMR. METHODS: A total of 226 subjects with CMR T1 mapping and HCT measurement 
      taken on the same day as the CMR were retrospectively enrolled and randomly split 
      into derivation (n = 121) and validation (n = 105) groups, comprising healthy 
      subjects (n = 45), type 2 diabetes mellitus (T2DM) patients (n = 60), 
      hypertrophic cardiomyopathy (HCM) patients (n = 93), and 28 other patients. 
      Correlation of T1(blood) with the measured HCT (HCTm) was established in the 
      derivation group and used in both the derivation and the validation groups. The 
      relationships between the ECV values derived from both the synthetic HCT (HCTsyn) 
      and HCTm were explored. In addition, the differences in the ECV values among the 
      HC, T2DMs, and HCMs were compared. RESULTS: Regression between the HCTm and 
      1/T1(blood) was linear (R(2) = 0.19, p < 0.001), and the regression equation was: 
      HCTsyn = [561.6*(1/T1blood)] + 0.098 in the derivation group. The measured ECV 
      (ECVm) was strongly correlated with the synthetic ECV (ECVsyn) (R(2) = 0.87, 
      p < 0.001) and mildly correlated with the difference between the ECVsyn and ECVm 
      (R(2) = 0.10, p < 0.001) in the derivation group. Also in this group, the ECVm 
      was larger in T2DMs than that in healthy cohort (29.1 +/- 3.1% vs. 26.4 +/- 2.4%, 
      p = 0.002), whereas, the ECVsyn did not differ between T2DMs and healthy cohort 
      (28.3 +/- 2.9% vs. 26.9 +/- 2.2%, p = 0.064). Compared with the healthy cohort, the 
      HCMs were associated with higher ECVsyn and ECVm of the mid-ventricle in both the 
      derivation and the validation groups. Using our center's normal cut-off of 31.8%, 
      the use of ECVsyn would lead to a 6-25% incorrect categorization of patients in 
      the derivation and validation groups. CONCLUSIONS: ECVsyn derived from HCTsyn may 
      lead to clinical errors in 3 T CMR, especially for patients who have only a 
      subtle elevation in ECV.
FAU - Shang, Yongning
AU  - Shang Y
AD  - Department of Radiology, Southwest Hospital, Third Military Medical University, 
      Gaotanyan Street No. 30, Shapingba district, Chongqing, China.
FAU - Zhang, Xiaochun
AU  - Zhang X
AD  - Department of Radiology, Southwest Hospital, Third Military Medical University, 
      Gaotanyan Street No. 30, Shapingba district, Chongqing, China. zxcylxyr@163.com.
FAU - Zhou, Xiaoyue
AU  - Zhou X
AD  - MR Collaboration, Siemens Healthcare Ltd., Shanghai, China.
FAU - Wang, Jian
AU  - Wang J
AUID- ORCID: 0000-0003-1210-0837
AD  - Department of Radiology, Southwest Hospital, Third Military Medical University, 
      Gaotanyan Street No. 30, Shapingba district, Chongqing, China. 
      wangjian_811@yahoo.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Validation Study
DEP - 20180809
PL  - England
TA  - J Cardiovasc Magn Reson
JT  - Journal of cardiovascular magnetic resonance : official journal of the Society 
      for Cardiovascular Magnetic Resonance
JID - 9815616
SB  - IM
MH  - Adult
MH  - Feasibility Studies
MH  - Female
MH  - Heart Diseases/*blood/*diagnostic imaging/pathology
MH  - *Hematocrit
MH  - Humans
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - Reproducibility of Results
MH  - Retrospective Studies
PMC - PMC6083590
OTO - NOTNLM
OT  - 3 T cardiovascular magnetic resonance
OT  - Extracellular volume fraction
OT  - Synthetic hematocrit
OT  - T1 mapping
COIS- The study was approved by the Southwest Hospital Ethics Committee (reference 
      number, 2016-Scientific-Research-No.50), and all the participants provided 
      written informed consent. The authors declare that they have no competing 
      interests. Springer Nature remains neutral with regard to jurisdictional claims 
      in published maps and institutional affiliations.
EDAT- 2018/08/10 06:00
MHDA- 2019/03/15 06:00
PMCR- 2018/08/09
CRDT- 2018/08/10 06:00
PHST- 2017/10/17 00:00 [received]
PHST- 2018/06/29 00:00 [accepted]
PHST- 2018/08/10 06:00 [entrez]
PHST- 2018/08/10 06:00 [pubmed]
PHST- 2019/03/15 06:00 [medline]
PHST- 2018/08/09 00:00 [pmc-release]
AID - S1097-6647(23)00593-8 [pii]
AID - 475 [pii]
AID - 10.1186/s12968-018-0475-6 [doi]
PST - epublish
SO  - J Cardiovasc Magn Reson. 2018 Aug 9;20(1):56. doi: 10.1186/s12968-018-0475-6.