Abstract 12924: Expansion of Extracellular Space Assessed by Post-contrast T1 Value is Closely Related to Diastolic Dysfunction and Neurohormonal Activation in Patients with Dilated Cardiomyopathy
Purpose: Both diastolic dysfunction and neurohormonal activation are important prognosticators in patients with dilated cardiomyopathy (DCM). However, relationship between degree of diffuse extracellular expansion quantified by post-contrast T1 mapping and LV diastolic function and degree of neurohormal activation has not been fully evaluated yet. In this study, we sought to evaluate the relationship between post-T1 value and LV diastolic function and neurohormonal activation assessed by LV mass/volume ratio, echo-Doppler indices and NT-pro BNP level.
Methods: Sixty-three patients with DCM who underwent both CMR and echocardiography were enrolled. Post-contrast-15 minutes T1 value was generated from TI scout images obtained by Look-Locker inversion recovery sequence by curve-fitting algorithm. T1 sample volume was obtained in three interventricular septal points and their average T1 value was used for the analysis. NT-proBNP was also measured as a biomarker of LV diastolic stretch in the 43 patients.
Results: Mean age was 56±15 years and 19 were women. Their mean LV ejection fraction was 23±9%, post-T1 value was 251.2±47.1 ms, and median NT-proBNP value was 3197 pg/ml, respectively. Post-T1 was significantly correlated with LV ejection fraction, systolic longitudinal septal velocity (s’), diastolic elastance index (Ed, E/e’/stroke volume), LV mass/volume ratio, and NT-proBNP. In multivariable analysis without NT-proBNP, post-T1 was correlated most strongly with LV mas/volume ratio (β=0.348, p=0.018), however when NT-proBNP entered, NT-proBNP was most strongly correlated with post-T1 (β= -0.39, p=0.010).
Conclusions: Degree of extracellular space expansion assessed by post-contrast T1 value closely related to diastolic function and neurohormonal activation as assessed by NT-proBNP independent of systolic function.
- © 2013 by American Heart Association, Inc.