Abstract
This study assessed the extent of fibrosis and the relationship between the ADC value and systolic strain in hypertensive patients with left ventricular hypertrophy (HTN LVH) and hypertensive patients without LVH (HTN non-LVH) using cardiac diffusion-weighted imaging and T1 mapping. T1 mapping was performed in 13 HTN LVH (mean age, 56.23 ± 3.30 years), 17 HTN non-LVH (mean age, 56.41 ± 2.78 years), and 12 normal control subjects (mean age, 55.67 ± 3.08 years) with 3.0 T MRI using cardiac diffusion-weighted imaging and T1 mapping. HTN LVH subjects had higher native T1 (1233.12 ± 79.01) compared with controls (1133.88 ± 27.40) (p < 0.05). HTN LVH subjects had higher ECV (0.28 ± 0.03) compared with HTN non-LVH subjects (0.26 ± 0.02) or controls (0.24 ± 0.03) (p < 0.05). HTN LVH subjects had higher ADC (2.23 ± 0.34) compared with HTN non-LVH subjects (1.88 ± 0.27) or controls (1.61 ± 0.38), (p < 0.05). Positive associations were noted between LVMI and ADC (Spearman = 0.450, p < 0.05) and between LVMI and ECV (Spearman = 0.181, p < 0.05). ADC was also related to an increase in ECV (R2 = 0.210). Increased levels of ADC were associated with reduced peak systolic and early diastolic circumferential strain rates across all subjects. Contrast-free DW-CMR is an alternative sequence to ECV for the evaluation of fibrosis extent in HTN LVH and HTN non-LVH, while native T1 has limited value.
Highlights
Hypertensive heart disease may exhibit different extents of fibrosis in different disease stages
Five of the 35 HTN subjects were excluded because they did not meet the criteria for LV hypertrophy (LVH) as an LV mass index (LVMI) that was greater than 61 g/m2 in women or 81 g/m2 in men as measured by CMR
A total of 30 patients were included in the study, and these subjects were further divided into 13 hypertensive patients with left ventricular hypertrophy (HTN LVH) subject (56.23 ± 3.30 years) and 17 HTN non-LVH subject
Summary
Hypertensive heart disease may exhibit different extents of fibrosis in different disease stages. Recent cardiovascular magnetic resonance approaches to determine diffuse myocardial fibrosis involve a sequence of LGE imaging[11, 12], post-contrast T1 mapping[13,14,15] and ECV mapping[16, 17]. Contrast-free quantitative cardiovascular magnetic resonance techniques, such as pre-contrast T1 mapping[18], diffusion imaging[19,20,21], T1 ρ imaging[22], and creatine chemical-exchange imaging[23], have revealed myocardial fibrosis (i.e., scar) in chronic myocardial infarction patients. We postulated that HTN LVH subjects would exhibit greater fibrosis, reduced systolic strain, and early diastolic strain rate compared to the other 2 groups
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call