Key result
CMR T1 mapping accurately measures myocardial collagen volume with moderate agreement to histology.
Why the study?
Right ventricular biopsy is the gold standard for myocardial fibrosis assessment but is invasive with complications and poor reproducibility, prompting investigation of non-invasive CMR methods to estimate total collagen volume.
Does CMR T1 mapping accurately estimate total collagen volume compared to histology in healthy pigs?
Does CMR T1 mapping accurately estimate total collagen volume compared to histology in healthy pigs?
Absolute Event Rate: 9% vs 8%
Estimation of total collagen volume through CMR T1 mapping shows good agreement with histology in a healthy pig model, offering a potential non-invasive method to assess myocardial collagen content.
T1 mapping may enable non-invasive collagen assessment in research; leaves open clinical adoption pending prospective validation.
Right ventricular biopsy represents the gold standard for the assessment of myocardial fibrosis and collagen content. This invasive technique, however, is accompanied by perioperative complications and poor reproducibility. Extracellular volume (ECV) measured through cardiovascular magnetic resonance (CMR) has emerged as a valid surrogate method to assess fibrosis non-invasively. Nonetheless, ECV provides an overestimation of collagen concentration since it also considers interstitial space. Our study aims to investigate the feasibility of estimating total collagen volume (TCV) through CMR by comparing it with the TCV measured at histology. Seven healthy Landrace pigs were acutely instrumented closed-chest and transported to the MRI facility for measurements. For each protocol, CMR imaging at 3T was acquired. MEDIS software was used to analyze T1 mapping and ECV for both the left ventricular myocardium (LVmyo) and left ventricular septum (LVseptum). ECV was then used to estimate TCVCMR at LVmyo and LVseptum following previously published formulas. Tissues were prepared following an established protocol and stained with picrosirius red to analyze the TCVhisto in LVmyo and LVseptum. TCV measured at LVmyo and LVseptum with both histology (8 ± 5 ml and 7 ± 3 ml, respectively) and T1-Mapping (9 ± 5 ml and 8 ± 6 ml, respectively) did not show any regional differences. TCVhisto and TCVCMR showed a good level of data agreement by Bland–Altman analysis. Estimation of TCV through CMR may be a promising way to non-invasively assess myocardial collagen content and may be useful to track disease progression or treatment response.
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Faragli et al. (2020) studied Healthy (n=7). T1 mapping (Cardiovascular Magnetic Resonance) vs. Histology (picrosirius red staining) was evaluated on Total collagen volume (TCV) in left ventricular myocardium. Total collagen volume measured by T1 mapping (9 ± 5 ml in LV myocardium) showed no significant difference and moderate agreement with histological measurements (8 ± 5 ml), suggesting CMR is a feasible non-invasive method.
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