T1 mapping in children and young adults with hypertrophic cardiomyopathy

Int J Cardiovasc Imaging. 2017 Jan;33(1):109-117. doi: 10.1007/s10554-016-0979-9. Epub 2016 Sep 22.

Abstract

To assess the global and segmental left ventricular (LV) native T1 and extracellular volume fraction (ECV) in children and young adults with hypertrophic cardiomyopathy (HCM) compared to a control cohort. The study population included 21 HCM patients (mean 14.1 ± 4.6 years) and 21 controls (mean 15.7 ± 1.5 years). Native modified Look-Locker inversion recovery sequence was performed before and after contrast injection in 3 short axis planes. Global and segmental LV native T1 and ECV were quantified and compared between HCM patients and controls. Mean native T1 in HCM patients and controls was 1020.4 ± 41.2 and 965.6 ± 30.2 ms respectively (p < 0.0001). Hypertrophied myocardium had significantly higher native global T1 and global ECV compared to non-hypertrophied myocardium in HCM (p < 0.0001, = 0.14 and 0.048, = 0.01 respectively). In a subset of patients, ECV was higher in LV segments with LGE compared to no LGE (p < 0.0001). No significant correlation was identified between global native T1 and ECV and parameters of LV structure and function. Native T1 cut-off of 987 ms provided the highest sensitivity (95 %) and specificity (91 %) to separate HCM patients from controls. Global and segmental native T1 are elevated in HCM patients. LV segments with hypertrophy and/or LGE had higher ECV in a subset of HCM patients. LV native T1 and ECV do not correlate with parameters of LV structure and function. T1 in children and young adults may be used as a non-invasive tool to assess for HCM and related fibrosis.

Keywords: Children; Hypertrophic cardiomyopathy; Magnetic resonance imaging; T1 mapping.

MeSH terms

  • Adolescent
  • Area Under Curve
  • Cardiomyopathy, Hypertrophic / diagnostic imaging*
  • Cardiomyopathy, Hypertrophic / pathology
  • Cardiomyopathy, Hypertrophic / physiopathology
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Contrast Media / administration & dosage
  • Female
  • Fibrosis
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging*
  • Hypertrophy, Left Ventricular / pathology
  • Hypertrophy, Left Ventricular / physiopathology
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging*
  • Male
  • Myocardium / pathology
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • Reproducibility of Results
  • Ventricular Function, Left*
  • Young Adult

Substances

  • Contrast Media