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Written informed consent was obtained from all subjects. By using a 1. Electrocardiogram monitoring leads were positioned with the subject in the supine position.
Vertical and horizontal LV long-axis cine images were acquired using a steady-state free precession sequence.
LV volumes and mass were calculated from an LV short-axis stack of cine images extending from the apex to the base repetition time, 3. Native T1 mapping was acquired using a slice-interleaved T1 STONE sequence which enables acquisition of 5 slices in the short-axis plane within a 90 sec free-breathing scan 14 repetition time, 2.
Fifteen minutes after the injection of 0.
To determine LV mass, epi- and endocardial LV borders were manually traced on the short axis images. LV mass was calculated as the sum of the myocardial volume multiplied by the specific gravity 1. Visual assessment was performed to assess presence or absence of myocardial enhancement on LGE images using the 16 segment model. For calculating LV native T1 time, the three short axis LV slices were divided into 6 segments for basal and mid-ventricular slices, 4 segments for apical slice using the anterior right ventricular-LV insertion point as reference.
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Motion correction was performed using the adaptive registration of varying contrast-weighted images for improved tissue characterization approach The 16 segment model was used to assess native T1 time in each segments. To evaluate inter-observer reproducibility, measurements of LV native T1 time from 10 HC patients were independently taken by two observers.
One of the two observers measured LV native T1 time twice to assess intra-observer reproducibility.
Data were analyzed using SPSS software version For continuous variables, normality was evaluated by Shapiro—Wilk test. Significance of difference was evaluated using unpaired-t test for normal distributed variables, Mann-Whitney U test for skewed variables.
Chi-square test was used to assess the difference for categorical variables. To evaluate reproducibility of native T1 time measurement, intraclass correlation coefficient ICC and repeatability coefficient were evaluated.
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Repeatability coefficients were calculated as 1. We measured LV native T1 time and maximum LV wall thickness in each 16 segments from 3 slices basal, mid-ventricular and apical-slice.
In conclusion, substantial number of segments without LGE showed elevation of native T1 time, and whole heart T1 mapping revealed heterogeneity of myocardial native T1 time in HC patients.
Keywords: Native T1 mapping, Hypertrophic cardiomyopathy, Heterogeneity Introduction Hypertrophic cardiomyopathy HC is a genetic heart disease, characterized by unexplained left ventricular LV hypertrophy, myofibrillar disarray and myocardial fibrosis 1.
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HC is regarded as the most common non-traumatic cause of sudden death in young generation 2. Post-mortem studies revealed that fibrosis is either present as focal fibrosis, or diffuse fibrosis by intercellular deposition of collagen fibers 3.
In-vivo, focal fibrosis can be assessed non-invasively with late gadolinium enhanced LGE magnetic resonance imaging MRI 4. Therefore, noninvasive assessment of diffuse interstitial fibrosis is of interest in terms of better risk stratification in HC patients.
Myocardial T1 mapping emerged as a non-invasive method to quantify diffuse myocardial abnormality. Extra cellular volume calculated by pre- and post- T1 mapping can detect diffuse myocardial abnormality in patients with diastolic heart failure 9 , diabetic cardiomyopathy 10 and cardiac amyloidosis Recent studies showed that native non-contrast T1 mapping can differentiate myocardial abnormality of HC from healthy myocardium However, in this study, myocardial T1 time was calculated by one point sampling of mid septal wall.
To date, no data are available regarding native T1 time heterogeneity based on 16 segment model.
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The aims of this study were to compare native T1 time between HC patients and healthy controls, and to evaluate spatial heterogeneity of native T1 time in HC patients using slice-interleaved T1 mapping. In our cohort, there were 6 HC patients with left ventricular outflow obstruction. Healthy controls had no history of hypertension, dyslipidemia, diabetes mellitus and smoking.
All participants were in sinus rhythm at the time of scan. The study protocol was approved by our institutional review board.
Written informed consent was obtained from all subjects. By using a 1.
Electrocardiogram monitoring leads were positioned with the subject in the supine position. Vertical and horizontal LV long-axis cine images were acquired using a steady-state free precession sequence.Singapore Thailand Vietnam Other Countries. Ask a Scientist Ask a Scientist.
In our cohort, there were 6 HC patients with left ventricular outflow obstruction. Thank you for verifying your email address. One of the two observers measured LV native T1 time twice to assess intra-observer reproducibility. The 16 segment model was used to assess native T1 time in each segments.
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