Assessment of Myocardial Microstructural Dynamics by In Vivo Diffusion Tensor Cardiac Magnetic Resonance
| Autor: | Philip J. Kilner, Robert S. Balaban, Peter D. Gatehouse, Dumitru Mazilu, Pedro F. Ferreira, Eric Aliotta, Archontis Giannakidis, Daniel B. Ennis, Andrew E. Arai, Ranil de Silva, Laura Ann McGill, Peter Kellman, Andrew D Scott, Dudley J. Pennell, Zohya Khalique, Majid Al-Khalil, Sonia Nielles-Vallespin, David N. Firmin |
|---|---|
| Přispěvatelé: | Heart Research UK, British Heart Foundation, Royal Brompton & Harefield NHS Foundation Trust |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Pathology Cardiac & Cardiovascular Systems Magnetic Resonance Spectroscopy Swine 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging 0302 clinical medicine sheetlet structure laminar structure 1102 Cardiorespiratory Medicine and Haematology Cardiac cycle medicine.diagnostic_test Ventricular Remodeling Hypertrophic cardiomyopathy Myocardial Perfusion Imaging Dilated cardiomyopathy WALL Heart Middle Aged WATER DIFFUSION EUROPEAN-SOCIETY Diffusion Tensor Imaging FIBER ORIENTATION helical structure Cardiology cardiovascular system Female Cardiology and Cardiovascular Medicine Life Sciences & Biomedicine MRI Adult Cardiomyopathy Dilated medicine.medical_specialty LEFT-VENTRICLE STRAIN left ventricle Diastole Magnetic Resonance Imaging Cine Article 1117 Public Health and Health Services 03 medical and health sciences Myocardial perfusion imaging LAMINAR ARCHITECTURE Internal medicine medicine Animals Humans cardiovascular diseases Systole Ventricular remodeling Aged Science & Technology business.industry Myocardium Cardiomyopathy Hypertrophic medicine.disease hypertrophic cardiomyopathy dilated cardiomyopathy Disease Models Animal Cardiovascular System & Hematology Case-Control Studies Cardiovascular System & Cardiology business Diffusion MRI TASK-FORCE |
| Zdroj: | Journal of the American College of Cardiology |
| ISSN: | 1558-3597 0735-1097 |
| Popis: | BACKGROUND Cardiomyocytes are organized in microstructures termed sheetlets that reorientate during left ventricular thickening. Diffusion tensor cardiac magnetic resonance (DT-CMR) may enable noninvasive interrogation of in vivo cardiac microstructural dynamics. Dilated cardiomyopathy (DCM) is a condition of abnormal myocardium with unknown sheetlet function. OBJECTIVES This study sought to validate in vivo DT-CMR measures of cardiac microstructure against histology, characterize microstructural dynamics during left ventricular wall thickening, and apply the technique in hypertrophic cardiomyopathy (HCM) and DCM. METHODS In vivo DT-CMR was acquired throughout the cardiac cycle in healthy swine, followed by in situ and ex vivo DT-CMR, then validated against histology. In vivo DT-CMR was performed in 19 control subjects, 19 DCM, and 13 HCM patients. RESULTS In swine, a DT-CMR index of sheetlet reorientation (E2A) changed substantially (E2A mobility ~46°). E2A changes correlated with wall thickness changes (in vivo r2 = 0.75; in situ r2 = 0.89), were consistently observed under all experimental conditions, and accorded closely with histological analyses in both relaxed and contracted states. The potential contribution of cyclical strain effects to in vivo E2A was ~17%. In healthy human control subjects, E2A increased from diastole (18°) to systole (65°; p < 0.001; E2A mobility = 45°). HCM patients showed significantly greater E2A in diastole than control subjects did (48 ; p < 0.001) with impaired E2A mobility (23°; p < 0.001). In DCM, E2A was similar to control subjects in diastole, but systolic values were markedly lower (40° ; p < 0.001) with impaired E2A mobility (20°; p < 0.001). CONCLUSIONS Myocardial microstructure dynamics can be characterized by in vivo DT-CMR. Sheetlet function was abnormal in DCM with altered systolic conformation and reduced mobility, contrasting with HCM, which showed reduced mobility with altered diastolic conformation. These novel insights significantly improve understanding of contractile dysfunction at a level of noninvasive interrogation not previously available in humans. (J Am Coll Cardiol 2017;69:661–76) Published by Elsevier on behalf of the American College of Cardiology Foundation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|