Abstract

ObjectiveRegional differences in cardiac magnetic resonance, which can reveal catecholamine-induced myocardial injury in patients with pheochromocytoma, have not yet been assessed using 3T magnetic resonance imaging. We evaluated these differences using myocardial T1-mapping and strain analysis.Design and MethodsWe retrospectively reviewed 16 patients newly diagnosed with catecholamine-producing tumors (CPT group) and 16 patients with essential hypertension (EH group), who underwent cardiac magnetic resonance imaging between May 2016 and March 2018. We acquired 3T magnetic resonance cine and native T1-mapping images and performed feature-tracking-based strain analysis in the former.ResultsGlobal cardiac function, morphology, global strain and peak strain rate were similar, but end-diastolic wall thickness differed between groups (CPT vs EH: 10.5 ± 1.7 vs 12.6 ± 2.8 mm; P < 0.05). Basal, but not apical, circumferential strain was significantly higher in the CPT than the EH group (19.4 ± 3.2 vs 16.8 ± 3.6 %; P < 0.05). Native T1 values were significantly higher in CPT than in EH patients, in both the basal septum (1307 ± 48 vs 1241 ± 45 ms; P < 0.01) and the apical septum (1377 ± 59 vs 1265 ± 58 ms; P < 0.01) mid-walls. In the CPT, but not in the EH group, native T1 values in the apical wall were significantly higher than those in the basal wall (P < 0.01).Conclusion3T magnetic resonance-based T1-mapping can sensitively detect subclinical catecholamine-induced myocardial injury; the influence of catecholamines may be greater in the apical than in the basal wall.

Highlights

  • Pheochromocytomas and paragangliomas are catecholamine-producing tumors (CPTs)

  • We aimed to evaluate whether Cardiac magnetic resonance (CMR) could detect subclinical catecholamine-induced cardiac injury in patients with CPTs, as compared to patients with essential hypertension (EH), using a 3T magnetic resonance (MR) scanner

  • Ferreira et al have reported a systemic study of catecholamine-induced cardiac injury using a 1.5T MR scanner [18]

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Summary

Introduction

Pheochromocytomas and paragangliomas are catecholamine-producing tumors (CPTs). The prevalence of pheochromocytoma in patients with hypertension in general outpatient clinics varies between 0.2 and 0.6% [1]. Excess catecholamines are secreted from the adrenal gland or extra-adrenal chromaffin cells in CPTs, spontaneously. Patients with these tumors may present with various clinical symptoms, such as episodic headaches, sweating, tachycardia, palpitations and paroxysmal hypertension [2]. The increase in catecholamine production can lead to high morbidity and mortality, due to catastrophic cardiovascular complications, including myocardial ischemia, aortic dissection, stroke, hypertensive crisis and peripheral ischemia [3, 4, 5, 6].

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