Abstract 13785: Late Gadolinium Enhancement in Magnetic Resonance Imaging has a Strong Relation with Microvascular Dysfunction and TransCardiac Troponin T Release in Non-Ischemic Heart Failure Patients

Abstract

BACKGROUND: Myocardial fibrosis defined as a key component of heart failure and since then various studies indicated a strong relationship between myocardial fibrosis and progression of heart failure. The utility of late gadolinium enhancement (LGE) in cardiac magnetic resonance imaging (MRI) for detecting myocardial fibrosis is well established. The prognostic value of LGE in non-ischemic heart failure has been described in several studies. Coronary flow reserve (CFR) in cardiac catheterization is a marker of microvascular dysfunction in the absence of coronary artery narrowing. CFR would be degraded in fibrotic tissue. We examined the relation between CER and LGE in non-ischemic heart failure patients.

METHODS: We evaluated LGE in MRI in 45 non-ischemic heart failure patients who were at stable condition. We performed cardiac catheterization in the patients, and evaluated coronary flow reserve (CFR) by using intracoronary doppler guidewire in left anterior descending artery(LAD) before and after administering adenosine. In addition, we sampled from aortic root (Ao) and coronary sinus (CS) simultaneously, measuring high sensitive serum cardiac troponin T and plasma B-type natriuretic peptide (BNP) levels.

RESULTS: In cardiac MRI, 27patients (62%) were positive for LGE, and 13 of them were positive for LGE in LAD area (LAD-LGE group: 30%). 14 patients were positive for LGE in non-LAD area (non-LAD-LGE group: 32%). 18patients were negative for LGE (LGE negative group: 38%). CFR in LAD of LAD-LGE group were significantly lower than that of non-LAD-LGE group and LGE negative group (1.52±0.604 versus 2.97±0.813, 2.79±0.546 respectively: p=0.001, p=0.01). Trans-cardiac troponin T release levels in LGE positive group were significantly higher than those from LGE negative group (5.63±6.64 versus 1.99±6.64pg/ml; p=0.03), but trans-cardiac BNP release levels were not correlate with LGE (239.2±165.6 versus 252.8±192.7ng/ml; p=0.8).

CONCLUSION: Microvascular dysfunction as a low CFR and trans-cardiac troponin T release would be occurred in myocardial tissue with LGE in non-ischemic heart failure patients.