Oxygenation-sensitive cardiovascular magnetic resonance in hypertensive heart disease with left ventricular myocardial hypertrophy and non-left ventricular myocardial hypertrophy: Insight from altered mechanics and cardiac BOLD imaging

J Magn Reson Imaging. 2018 Nov;48(5):1297-1306. doi: 10.1002/jmri.26055. Epub 2018 May 7.

Abstract

Background: BOLD (blood oxygen level dependent) MRI can detect regional condition of myocardial oxygen supply and demand by means of paramagnetic properties.

Purpose: Noninvasive assessment of myocardial oxygenation by BOLD MRI in hypertensive patients with hypertension (HTN) left ventricular myocardial hypertrophy (LVMH) and HTN non-LVMH and its correlation with myocardial mechanics were performed.

Study type: Prospective.

Population: Twenty patients with HTN LVMH, 21 patients with HTN non-LVMH, and 23 normotensive controls were enrolled.

Field strength/sequence: Cine imaging, T2* and T1 mapping sequences were achieved at 3.0T.

Assessment: Dedicated T1 mapping, T2*, and cine imaging analysis were performed by two radiologists using cvi42.

Statistical tests: One-way analysis of variance, Kruskal-Wallis test, Bland-Altman analysis, Pearson's correlation coefficient, Spearman's rank correlation.

Results: T2* values of HTN LVMH group were significantly lower versus the controls (23.78 ± 3.09 versus 30.77 ± 2.71; P < 0.001) and HTN non-LVMH group (23.78 ± 3.09 versus 28.64 ± 4.23; P < 0.001). Left ventricular peak circumferential strain were reduced in HTN LVMH patients compared with other two groups (-11.32 [-15.64, -10.3], -16.78 [-19.35, -15.34], and -19.73 [-20.57, -18.73]; P < 0.05); and longitudinal strain of HTN LVMH patients were lower than other two groups (-11.31 ± 2.91, -15.1 ± 3.06, and -18.85 ± 1.85; P < 0.05); radial strain of HTN LVMH patients were also lower than other two groups (25.03 ± 16, 40.95 ± 17.5 and 47.9 ± 10.23; P < 0.05). Extracellular volume correlated with peak circumferential, longitudinal, and radial strain (spearman rho = 0.6, 0.64, and -0.69; P < 0.05), respectively; T2* negatively correlated with peak circumferential and longitudinal strain (spearman rho = -0.43 and -0.49; P < 0.05), respectively. Patients with lower T2* values had significant decreases in myocardial mechanics (P < 0.05).

Data conclusion: HTN LVMH patients have both impaired myocardial mechanics and decreased T2* values compared with HTN non-LVMH and normotensive groups. BOLD MRI could provide a feasible assessment modality for detecting altered T2* due to the change of de-oxygenated hemoglobin and hence to the change of signal intensity in oxygenation-sensitive images.

Level of evidence: 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1297-1306.

Keywords: blood oxygen level dependent; cardiac magnetic resonance imaging; hypertensive heart disease; myocardial strain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Heart Diseases / diagnostic imaging*
  • Heart Ventricles / diagnostic imaging
  • Hemoglobins / analysis
  • Humans
  • Hypertension / diagnostic imaging*
  • Hypertrophy, Left Ventricular / diagnostic imaging*
  • Magnetic Resonance Imaging, Cine*
  • Male
  • Middle Aged
  • Myocardium / metabolism
  • Myocardium / pathology
  • Oxygen / blood
  • Oxygen / chemistry*
  • Prospective Studies

Substances

  • Hemoglobins
  • Oxygen