Author + information
- Allen Weiss,
- Juan Antonio Requena Ibanez,
- Chirag Agarwal,
- Rebecca Smoller,
- Johanna Contreras,
- Jagat Narula,
- Valentin Fuster,
- Juan Badimon,
- Angel Sanz Salvo,
- Carlos Santos-Gallego and
- Mount Sinai
Introduction: The mechanism causing heart failure with preserved ejection fraction (HFPEF) is not clear, but interstitial myocardial fibrosis (IMF) has been proposed to have a causal role. T1 mapping is able to quantify IMF non-invasively. The aim of our study was to assess IMF in HFPEF patients using T1 mapping.
Methods: We included consecutive patients with HFPEF who underwent cardiac magnetic resonance (CMR), reviewed their clinical histories, and compared them with healthy controls. HFPEF was defined as symptoms and signs of HF in the presence of left ventricular (LV) ejection fraction (LVEF) >50%, evidence of diastolic dysfunction, and the absence of any other causes. T1 mapping was performed from a Look-Locker sequence 10 minutes after gadolinium injection. Myocardial mechanics were quantified using CMR-strains (feature-tracking). Diastolic function was assessed by echocardiography, and LV filling pressures were obtained from catheterization.
Results: We included 92 HFPEF patients (n=92, 60±15 years, 59% female) and 46 controls (n=46, 59±13 years, 60% female). There were no differences in age, gender or anthropometric measures between both groups. Post-contrast T1 relaxation times were significantly shorter in HFPEF patients vs. controls (398±51 vs. 424±37ms, p<0.01), suggesting a higher degree of IMF in HFPEF. T1 times inversely correlated with sensitive parameters of LV systolic function such as longitudinal and circumferential strain (r= -0.65 and -0.49, respectively, p<0.05 for both) but not with LVEF. T1 times correlated with impairment in diastolic function: E’ (r=0.42), E/E’ (r= -0.55), and left atrial size (r= -0.61, p<0.05 for all). Finally, T1 times also correlated with severity of HF based on LV end-diastolic pressure (r= -0.59), brain natriuretic peptide levels (r= -0.55) and length of hospitalization (r= -0.46, p<0.05 for all).
Conclusions:_HFPEF patients exhibited increased IMF compared with healthy controls, as demonstrated by shorter post-contrast T1 times. This increased IMF correlates with and probably contributes to impaired diastolic function and HF severity in HFPEF. T1 mapping is a promising tool for the evaluation of HFPEF.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: MR Heart Failure and Pulmonary Hypertension
Abstract Category: 29. Non Invasive Imaging: MR
Presentation Number: 1158-203
- 2017 American College of Cardiology Foundation