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T1andT2mapping for early diagnosis of dilated non-ischaemic cardiomyopathy in middle-aged patients and differentiation from normal physiological adaptation
- Source :
- European Heart Journal – Cardiovascular Imaging. 17:797-803
- Publication Year :
- 2015
- Publisher :
- Oxford University Press (OUP), 2015.
-
Abstract
- Aims The differential diagnosis of patients with early non-ischaemic dilated cardiomyopathy (DCM) and those with physiological adaptation to exercise (‘athlete's heart’) may be difficult as many of the morphological adaptations are shared in the two conditions. Increased physical fitness is becoming more common in later adulthood, a group in whom there may be even more diagnostic difficulty. We hypothesized that tissue characterization using cardiovascular magnetic resonance (CMR) T 1 and T 2 mapping would be able to differentiate between patients with left ventricular (LV) dilatation due to early DCM and exercisers. Methods and results Fifty-eight middle-aged males [21 healthy controls, 21 males with a history of aerobic exercise and LV ejection fraction (LVEF) 45–55%, and 16 patients with DCM and LVEF 45–55%] underwent a CMR protocol including T 1 and T 2 mapping and calculation of extracellular volume (ECV) using a 1.5 T MRI scanner. Native T 1, ECV, and T 2 relaxation times were significantly increased in DCM patients compared with controls (native T 1 1017 ± 42 vs. 952 ± 31 ms, P < 0.001; ECV 31.2 ± 4.1 vs. 26.2 ± 2.9%, P = 0.003; T 2 55.9 ± 4.4 vs. 52.9 ± 3.3 ms, P = 0.05) and exercisers (native T 1 957 ± 32 ms, P < 0.001; ECV 26.3 ± 3.6%, P = 0.004; T 2 52.8 ± 3.2 ms, P = 0.042). Using multivariable logistic regression, native T 1 gave the best differentiation between exercisers and sedentary patients with early DCM (area under the curve 0.91). Conclusion T 1 and T 2 mapping are potentially useful tools for differentiating between athlete's heart and patients with early DCM, and could be used whenever differentiation between these two phenotypes is inconclusive using standard imaging techniques.
- Subjects :
- Cardiomyopathy, Dilated
Male
medicine.medical_specialty
Myocardial Ischemia
Magnetic Resonance Imaging, Cine
030204 cardiovascular system & hematology
Risk Assessment
Severity of Illness Index
Ventricular Function, Left
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Reference Values
Internal medicine
Severity of illness
Image Processing, Computer-Assisted
medicine
Humans
Aerobic exercise
Radiology, Nuclear Medicine and imaging
cardiovascular diseases
Analysis of Variance
Exercise Tolerance
Ejection fraction
medicine.diagnostic_test
business.industry
Area under the curve
Stroke Volume
Magnetic resonance imaging
Dilated cardiomyopathy
General Medicine
Stroke volume
Middle Aged
Prognosis
medicine.disease
Adaptation, Physiological
Early Diagnosis
Case-Control Studies
Predictive value of tests
Multivariate Analysis
Cardiology
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 20472412 and 20472404
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- European Heart Journal – Cardiovascular Imaging
- Accession number :
- edsair.doi.dedup.....c21eae1b2a6410ad712558617b6521a3
- Full Text :
- https://doi.org/10.1093/ehjci/jev216