科研之友
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摘要
Diffuse myocardial fibrosis is involved in the pathology of nonischemic cardiomyopathy (NIC). Recently, the application of native (noncontrast) myocardial T-1 measurement has been proposed as a method for characterizing diffuse interstitial fibrosis. To determine the association of native T-1 with myocardial structure and function, we prospectively studied 39 patients with NIC (defined as left ventricular ejection fraction (LVEF) <= 50% without cardiac magnetic resonance (CMR) evidence of previous infarction) and 27 subjects with normal LVEF without known overt cardiovascular disease. T-1, T-2, and extracellular volume fraction (ECV) were determined over 16 segments across the base, mid, and apical left ventricular (LV). NIC participants (57 +/- 15 years) were predominantly men (74%), with a mean LVEF 34 +/- 10%. Subjects with NIC had a greater native T-1 (1,131 +/- 51 vs 1,069 +/- 29 ms; p <0.0001), a greater ECV (0.28 +/- 0.04 vs 0.25 +/- 0.02, p = 0.002), and a longer myocardial T-2 (52 +/- 8 vs 47 +/- 5 ms; p = 0.02). After multivariate adjustment, a lower global native T-1 time in NIC was associated with a greater LVEF (beta = -0.59, p = 0.0003), greater right ventricular ejection fraction (beta = -0.47, p = 0.006), and smaller left atrial volume index (beta = 0.51, p = 0.001). The regional distribution of native myocardial T-1 was similar in patients with and without NIC. In NIC, native myocardial T-1 is elevated in all myocardial segments, suggesting a global (not regional) abnormality of myocardial tissue composition. In conclusion, native T-1 may represent a rapid, noncontrast alternative to ECV for delineating myocardial tissue remodeling in NIC.
- 出版日期2016-1-15
