A history of preeclampsia was associated with significantly elevated cardiac T1ρ relaxation times in postpartum women compared to controls (44.7 vs. 42.8 ms; p=0.021), indicating myocardial fibrosis.
Cross-Sectional (n=46)
Does a history of preeclampsia associate with elevated myocardial fibrosis as detected by T1Rho mapping in postpartum women compared to controls?
T1Rho mapping detects subclinical myocardial fibrosis in postpartum women with a history of preeclampsia, even when conventional CMR measures of cardiac structure and function remain normal.
Absolute Event Rate: 44.7% vs 42.8%
p-value: p=0.021
Abstract Background Preeclampsia (PEC), a pregnancy-specific condition, is associated with increased cardiovascular (CV) risk. Although subclinical cardiac dysfunction has been reported in PEC, the contribution of myocardial fibrosis and inflammation remains unclear. A novel CV MRI (CMR), mapping parameter known as T1ρ, quantifies myocardial fibrosis without contrast. However, its utility in postpartum women with a history of preeclampsia—a population characterized by chronic inflammation—remains unknown. We hypothesized that cardiac T1ρ is elevated in women with preeclampsia compared to controls, furthermore, we also evaluated reproducibility of the measure. Methods In this cross-sectional study, 46 prospectively enrolled postpartum women underwent CMR 3–9 months after delivery, including 23 with a history of PEC and 23 age-matched controls without PEC. Standard cine imaging quantified left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), and left ventricular mass (LVM). T1ρ mapping was performed using a spin-lock prepared gradient echo sequence. Group comparisons used Welch’s t-tests, with p0.05 denoting significance. Results Demographic characteristics, including age (34.2±6.1 yrs vs. 32.1±4.4 yrs; p=0.17) and body mass index (29.3±6.8 kg/m² vs. 26.3±5.2 kg/m²; p=0.10), were comparable. Women with prior PEC demonstrated significantly elevated T1ρ relaxation times compared to controls (44.7±2.2 ms vs. 42.8±3.1 ms; p=0.021). In contrast, conventional CMR measures of EDV (123±21 mL vs. 122±23 mL; p=0.82), ESV (45.8 ± 14.6 mL vs. 45.9±14.7 mL; p=0.97), EF (63.5±6.3% vs. 63.0±5.8%; p=0.80), and LVM (95.6±29.6 g vs. 85.3±17.6 g; p=0.16) showed no significant differences between groups. Reproducibility of myocardial T1ρ mapping was assessed using a two-way mixed-effects, ICC (intraclass correlation coefficient) for 10 postpartum subjects by 2 blinded, independent readers and ICC was 0.90 and 0.94 for inter and intra observer reproducibility. Conclusions Postpartum women with preeclampsia had higher cardiac T1ρ, a reproducible measure of myocardial fibrosis, compared to controls. In contrast, no difference was found in conventional CMR measures of cardiac structure and function between groups. These findings indicate that preeclampsia is associated with postpartum myocardial fibrosis and edema, and may contribute to increased long-term CV risk.Example of Cardiac T1Rho in Participants
Sheikh et al. (Thu,) conducted a cross-sectional in Preeclampsia (n=46). History of preeclampsia vs. Age-matched controls without preeclampsia was evaluated on Cardiac T1ρ relaxation times (p=0.021). A history of preeclampsia was associated with significantly elevated cardiac T1ρ relaxation times in postpartum women compared to controls (44.7 vs. 42.8 ms; p=0.021), indicating myocardial fibrosis.
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