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Characterization of diffuse fibrosis in the failing human heart via diffusion tensor imaging and quantitative histological validation.
- Source :
-
NMR in biomedicine [NMR Biomed] 2014 Nov; Vol. 27 (11), pp. 1378-86. Date of Electronic Publication: 2014 Sep 09. - Publication Year :
- 2014
-
Abstract
- Non-invasive imaging techniques are highly desirable as an alternative to conventional biopsy for the characterization of the remodeling of tissues associated with disease progression, including end-stage heart failure. Cardiac diffusion tensor imaging (DTI) has become an established method for the characterization of myocardial microstructure. However, the relationships between diffuse myocardial fibrosis, which is a key biomarker for staging and treatment planning of the failing heart, and measured DTI parameters have yet to be investigated systematically. In this study, DTI was performed on left ventricular specimens collected from patients with chronic end-stage heart failure as a result of idiopathic dilated cardiomyopathy (n = 14) and from normal donors (n = 5). Scalar DTI parameters, including fractional anisotropy (FA) and mean (MD), primary (D1 ), secondary (D2 ) and tertiary (D3 ) diffusivities, were correlated with collagen content measured by digital microscopy. Compared with hearts from normal subjects, the FA in failing hearts decreased by 22%, whereas the MD, D2 and D3 increased by 12%, 14% and 24%, respectively (P < 0.01). No significant change was detected for D1 between the two groups. Furthermore, significant correlation was observed between the DTI scalar indices and quantitative histological measurements of collagen (i.e. fibrosis). Pearson's correlation coefficients (r) between collagen content and FA, MD, D2 and D3 were -0.51, 0.59, 0.56 and 0.62 (P < 0.05), respectively. The correlation between D1 and collagen content was not significant (r = 0.46, P = 0.05). Computational modeling analysis indicated that the behaviors of the DTI parameters as a function of the degree of fibrosis were well explained by compartmental exchange between myocardial and collagenous tissues. Combined, these findings suggest that scalar DTI parameters can be used as metrics for the non-invasive assessment of diffuse fibrosis in failing hearts.<br /> (Copyright © 2014 John Wiley & Sons, Ltd.)
- Subjects :
- Adult
Aged
Anisotropy
Biopsy
Cardiomyopathy, Dilated complications
Cardiomyopathy, Dilated pathology
Collagen analysis
Computer Simulation
Female
Fibrosis
Heart Ventricles chemistry
Heart Ventricles pathology
Humans
Male
Middle Aged
Models, Cardiovascular
Monte Carlo Method
Myocardium chemistry
Young Adult
Diffusion Tensor Imaging methods
Heart Failure pathology
Myocardium pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1099-1492
- Volume :
- 27
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- NMR in biomedicine
- Publication Type :
- Academic Journal
- Accession number :
- 25200106
- Full Text :
- https://doi.org/10.1002/nbm.3200