Abstract 11232: Assessment of Diffuse Myocardial Fibrosis With Native T1 Values on Cardiovascular Magnetic Resonance and Its Relationship With Myocardial Function in Asymptomatic Aortic Stenosis Patients
Introduction: Aortic stenosis (AS) typically provokes diffuse myocardial fibrosis (DMF). Methods to evaluate DMF using cardiovascular magnetic resonance (CMR) are yet to be made easier and validated for wide clinical use.
Hypothesis: To test whether T1 mapping, without the use of gadolinium contrast, may be useful for assessment of DMF and whether it correlates with subclinical myocardial dysfunction in asymptomatic AS patients.
Methods: 80 asymptomatic patients with moderate or severe AS and normal LVEF and 15 sex-matched control subjects were prospectively enrolled. Patients underwent 2D-echocardiography, speckle tracking imaging and CMR in a 3.0T scanner including mapping of T1 relaxation time with modified Look-Locker Inversion-recovery (MOLLI) sequence. Patients were divided into three groups according to the native T1 value.
Results: Native T1 values correlated well with the degree of DMF on intraoperative myocardial biopsy specimens (r=0.777, p-value<0.001) and differed significantly between AS and control subjects (1208±45 vs. 1169±21(msec), p-value<0.001). LV volumes and mass were significantly different between the tertiles (80.8±10.3 vs. 93.4±23.1 vs. 121.5±37.9(mL/m2), 78.0±18.3 vs. 93.4±29.7 vs. 121.1±44.3(g/m2) for LV end-diastolic volume index and LV mass index, all p-value<0.001) as well as the degree of AS severity (0.55±0.14 vs. 0.46±0.12 vs. 0.45±0.13(cm2/m2), p-value=0.008 for indexed aortic valve area on echocardiography). Native T1 significantly correlated with global longitudinal strain by 2D-speckle trackle imaging (r=0.598, p-value<0.001), e’ velocity (r=-0.437, p-value<0.001) and indexed left atrial volume (r=0.475, p-value<0.001).
Conclusion: Native T1 value using MOLLI sequence in asymptomatic AS patients enables noninvasive, simple quantification of DMF and correlates well with subclinical LV systolic and diastolic dysfunction.
Author Disclosures: S. Lee: None. W. Lee: None. E. Park: None. H. Kim: None. Y. Kim: None. D. Sohn: None.
- © 2014 by American Heart Association, Inc.