Identification of myocardial extracellular matrix expansion by cardiac MRI in hypertensive patients

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Systemic hypertension with left ventricular hypertrophy (n=19). Intervention: Cardiac MRI for MECVF quantification vs. Normotensive controls. Primary outcome: Myocardial extracellular volume fraction (MECVF) (p=<0.0001).

François‐Pierre Mongeon; Michael Jerosch‐Herold; Otávio R. Coelho‐Filho; Luciana F Seabra; Eri Watanabe; Ron Blankstein; Raymond Y. Kwong

doi:10.1186/1532-429x-13-s1-o109

February 2, 2011Journal of Cardiovascular Magnetic ResonanceOpen Access

Identification of myocardial extracellular matrix expansion by cardiac MRI in hypertensive patients

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Key result

Cardiac MRI demonstrated a significantly increased myocardial extracellular volume fraction in hypertensive patients compared to normotensive controls (0.34 vs. 0.24, p<0.0001).

Why the study?

Does 3T cardiac MRI with T1 mapping detect increased myocardial extracellular volume fraction in hypertensive patients with LVH compared to normotensive controls?

Study Design

Type

Observational (n=19)

Multicenter

No

Structured PICO

Does 3T cardiac MRI with T1 mapping detect increased myocardial extracellular volume fraction in hypertensive patients with LVH compared to normotensive controls?

P

Population

19 subjects including 10 patients with systemic hypertension, left ventricular hypertrophy (LVH) by ECG or echocardiography, LVEF ≥50%, and no late gadolinium enhancement (mean age 65±15 years, 40% female), and 9 normotensive control subjects (mean age 45±11 years, 66.7% female).

I

Intervention

3T cardiac MRI with T1 mapping (Look-Locker gradient echo technique) pre- and post-gadolinium (0.15 mmol/Kg) to measure myocardial extracellular volume fraction (MECVF).

C

Comparator

Normotensive control subjects undergoing the same cardiac MRI protocol.

O

Outcome

Myocardial extracellular volume fraction (MECVF).surrogate

Main Result

Absolute Event Rate: 0.34% vs 0.24%

p-value: p=<0.0001

Cardiac MRI T1 mapping identifies increased myocardial extracellular volume fraction in hypertensive patients with LVH, suggesting it can detect diffuse fibrosis before replacement fibrosis occurs.

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Implication

Suggests CMR T1 mapping detects diffuse fibrosis in hypertensive LVH; hypothesis-generating and requires prospective outcome validation before clinical adoption.

Abstract

Background Left ventricular hypertrophy (LVH) is an important marker of adverse prognosis in cardiovascular disease and commonly occurs in association with hypertension. While late gadolinium enhancement (LGE) reflects myocardial replacement fibrosis in hypertensive patients, we hypothesized that the myocardial extracellular volume fraction (MECVF) would better reflect the presence and severity of myocardial fibrosis, including diffuse fibrosis, in hypertensive patients with LVH. We sought to measure the MECVF directly using T1 imaging preand post-contrast.

Discussion

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Cite This Study

Mongeon et al. (2011) conducted an observational in Systemic hypertension with left ventricular hypertrophy (n=19). Cardiac MRI for MECVF quantification vs. Normotensive controls was evaluated on Myocardial extracellular volume fraction (MECVF) (p=<0.0001). Cardiac MRI demonstrated a significantly increased myocardial extracellular volume fraction in hypertensive patients compared to normotensive controls (0.34 vs. 0.24, p<0.0001).

synapsesocial.com/papers/6a089513113ba5b476de4c91 https://doi.org/10.1186/1532-429x-13-s1-o109

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Identification of myocardial extracellular matrix expansion by cardiac MRI in hypertensive patients

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Identification of myocardial extracellular matrix expansion by cardiac MRI in hypertensive patients

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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