Probing the intravascular and interstitial compartments of remodeled myocardium in heart failure patients with preserved and reduced ejection fraction: a CMR study.
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5 janvier 2019
- doi: 10.1186/s12880-018-0301-5
- issn: 1471-2342
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info:eu-repo/semantics/altIdentifier/doi/10.1186/s12880-018-0301-5
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info:eu-repo/semantics/altIdentifier/pmid/30611240
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info:eu-repo/semantics/altIdentifier/eissn/1471-2342
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info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_0E4AD777E62B5
info:eu-repo/semantics/openAccess , CC BY 4.0 , https://creativecommons.org/licenses/by/4.0/
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P.G. Masci et al., « Probing the intravascular and interstitial compartments of remodeled myocardium in heart failure patients with preserved and reduced ejection fraction: a CMR study. », Serveur académique Lausannois, ID : 10.1186/s12880-018-0301-5
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Recent autopsy studies found microvascular rarefaction in remodeled myocardium of patients who died of heart failure with preserved ejection-fraction (HFpEF). This condition has not been investigated so far by non-invasive methods in patients with HFpEF. The aim was to quantify the intravascular volume (IVV) compartment by CMR in HFpEF patients. In two separate CMR examinations, HFpEF patients (n = 6; 12 examinations) and post-myocardial infarction patients (post-MI; n = 6; 12 examinations) were studied with T 1 -mapping (MOLLI-sequence) before and after IV bolus of 0.03 mmol/Kg of the intravascular contrast-medium (CM) Gadofosveset and 0.2 mmol/Kg of the extravascular CM Gadobutrol yielding IVV and extracellular volume (ECV), respectively. Healthy controls (n = 10 with Gadofosveset only, n = 10 with Gadobutrol only) were also studied with the same protocol. IVV and ECV were measured in the basal septum (without ischemic scar in post-MI patients). In post-MI patients, ECV and IVV were also measured in the ischemic scar. Left ventricular (LV) volumes, mass, and ejection-fraction were measured by standard protocol. LV global longitudinal strain (GLS) was calculated by feature tracking on long-axis cine acquisitions. LV mass to end-diastolic volume ratio and GLS in HFpEF were higher and lower, respectively, than in healthy controls and post-MI patients, whereas the post-MI patients showed lower LV ejection-fraction. Compared to healthy myocardium of controls, IVV in scar was reduced (0.135 ± 0.018 vs 0.109 ± 0.008, respectively, p = 0.005), while ECV was increased (0.244 ± 0.037 vs 0.698 ± 0.106, respectively, p