T1 and T2 mapping for early diagnosis of dilated non-ischaemic cardiomyopathy in middle-aged patients and differentiation from normal physiological adaptation

Ify Mordi, David Carrick, Hiram Bezerra, Nikolaos Tzemos

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Aims The differential diagnosis of patients with early non-ischaemic dilated cardiomyopathy (DCM) and those with physiological adaptation to exercise ('athlete's heart') may be difficult as many of the morphological adaptations are shared in the two conditions. Increased physical fitness is becoming more common in later adulthood, a group in whom there may be even more diagnostic difficulty.We hypothesized that tissue characterization using cardiovascular magnetic resonance (CMR) T1 and T2 mapping would be able to differentiate between patients with left ventricular (LV) dilatation due to early DCM and exercisers. Methods and results Fifty-eight middle-aged males [21 healthy controls, 21 males with a history of aerobic exercise and LV ejection fraction (LVEF) 45-55%, and 16 patients with DCMand LVEF 45-55%] underwent a CMR protocol including T1 and T2 mapping and calculation of extracellular volume (ECV) using a 1.5 T MRI scanner. Native T1, ECV, and T2 relaxation times were significantly increased in DCM patients compared with controls (native T1 1017±42 vs. 952±31 ms, P < 0.001; ECV 31.2±4.1 vs. 26.2±2.9%, P = 0.003; T2 55.9±4.4 vs. 52.9±3.3 ms, P = 0.05) and exercisers (native T1 957±32 ms, P < 0.001; ECV 26.3±3.6%, P = 0.004; T2 52.8±3.2 ms, P = 0.042). Using multivariable logistic regression, native T1 gave the best differentiation between exercisers and sedentary patients with early DCM (area under the curve 0.91). Conclusion T1 and T2 mapping are potentially useful tools for differentiating between athlete's heart and patients with early DCM, and could be used whenever differentiation between these two phenotypes is inconclusive using standard imaging techniques. Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2015.

Original languageEnglish
Pages (from-to)797-803
Number of pages7
JournalEuropean Heart Journal Cardiovascular Imaging
Volume17
Issue number7
DOIs
Publication statusPublished - 1 Jul 2016

Fingerprint

Physiological Adaptation
Cardiomyopathies
Dilated Cardiomyopathy
Early Diagnosis
Athletes
Magnetic Resonance Spectroscopy
Exercise
Physical Fitness
Stroke Volume
Area Under Curve
Dilatation
Differential Diagnosis
Logistic Models
Phenotype

Keywords

  • Athletes
  • Cardiovascular magnetic resonance
  • Dilated cardiomyopathy
  • T mapping

Cite this

@article{eac7973352b744658a814b1e34e82e7f,
title = "T1 and T2 mapping for early diagnosis of dilated non-ischaemic cardiomyopathy in middle-aged patients and differentiation from normal physiological adaptation",
abstract = "Aims The differential diagnosis of patients with early non-ischaemic dilated cardiomyopathy (DCM) and those with physiological adaptation to exercise ('athlete's heart') may be difficult as many of the morphological adaptations are shared in the two conditions. Increased physical fitness is becoming more common in later adulthood, a group in whom there may be even more diagnostic difficulty.We hypothesized that tissue characterization using cardiovascular magnetic resonance (CMR) T1 and T2 mapping would be able to differentiate between patients with left ventricular (LV) dilatation due to early DCM and exercisers. Methods and results Fifty-eight middle-aged males [21 healthy controls, 21 males with a history of aerobic exercise and LV ejection fraction (LVEF) 45-55{\%}, and 16 patients with DCMand LVEF 45-55{\%}] underwent a CMR protocol including T1 and T2 mapping and calculation of extracellular volume (ECV) using a 1.5 T MRI scanner. Native T1, ECV, and T2 relaxation times were significantly increased in DCM patients compared with controls (native T1 1017±42 vs. 952±31 ms, P < 0.001; ECV 31.2±4.1 vs. 26.2±2.9{\%}, P = 0.003; T2 55.9±4.4 vs. 52.9±3.3 ms, P = 0.05) and exercisers (native T1 957±32 ms, P < 0.001; ECV 26.3±3.6{\%}, P = 0.004; T2 52.8±3.2 ms, P = 0.042). Using multivariable logistic regression, native T1 gave the best differentiation between exercisers and sedentary patients with early DCM (area under the curve 0.91). Conclusion T1 and T2 mapping are potentially useful tools for differentiating between athlete's heart and patients with early DCM, and could be used whenever differentiation between these two phenotypes is inconclusive using standard imaging techniques. Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2015.",
keywords = "Athletes, Cardiovascular magnetic resonance, Dilated cardiomyopathy, T mapping",
author = "Ify Mordi and David Carrick and Hiram Bezerra and Nikolaos Tzemos",
year = "2016",
month = "7",
day = "1",
doi = "10.1093/ehjci/jev216",
language = "English",
volume = "17",
pages = "797--803",
journal = "European Heart Journal - Cardiovascular Imaging",
issn = "2047-2404",
publisher = "Oxford University Press",
number = "7",

}

T1 and T2 mapping for early diagnosis of dilated non-ischaemic cardiomyopathy in middle-aged patients and differentiation from normal physiological adaptation. / Mordi, Ify; Carrick, David; Bezerra, Hiram; Tzemos, Nikolaos.

In: European Heart Journal Cardiovascular Imaging, Vol. 17, No. 7, 01.07.2016, p. 797-803.

Research output: Contribution to journalArticle

TY - JOUR

T1 - T1 and T2 mapping for early diagnosis of dilated non-ischaemic cardiomyopathy in middle-aged patients and differentiation from normal physiological adaptation

AU - Mordi, Ify

AU - Carrick, David

AU - Bezerra, Hiram

AU - Tzemos, Nikolaos

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Aims The differential diagnosis of patients with early non-ischaemic dilated cardiomyopathy (DCM) and those with physiological adaptation to exercise ('athlete's heart') may be difficult as many of the morphological adaptations are shared in the two conditions. Increased physical fitness is becoming more common in later adulthood, a group in whom there may be even more diagnostic difficulty.We hypothesized that tissue characterization using cardiovascular magnetic resonance (CMR) T1 and T2 mapping would be able to differentiate between patients with left ventricular (LV) dilatation due to early DCM and exercisers. Methods and results Fifty-eight middle-aged males [21 healthy controls, 21 males with a history of aerobic exercise and LV ejection fraction (LVEF) 45-55%, and 16 patients with DCMand LVEF 45-55%] underwent a CMR protocol including T1 and T2 mapping and calculation of extracellular volume (ECV) using a 1.5 T MRI scanner. Native T1, ECV, and T2 relaxation times were significantly increased in DCM patients compared with controls (native T1 1017±42 vs. 952±31 ms, P < 0.001; ECV 31.2±4.1 vs. 26.2±2.9%, P = 0.003; T2 55.9±4.4 vs. 52.9±3.3 ms, P = 0.05) and exercisers (native T1 957±32 ms, P < 0.001; ECV 26.3±3.6%, P = 0.004; T2 52.8±3.2 ms, P = 0.042). Using multivariable logistic regression, native T1 gave the best differentiation between exercisers and sedentary patients with early DCM (area under the curve 0.91). Conclusion T1 and T2 mapping are potentially useful tools for differentiating between athlete's heart and patients with early DCM, and could be used whenever differentiation between these two phenotypes is inconclusive using standard imaging techniques. Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2015.

AB - Aims The differential diagnosis of patients with early non-ischaemic dilated cardiomyopathy (DCM) and those with physiological adaptation to exercise ('athlete's heart') may be difficult as many of the morphological adaptations are shared in the two conditions. Increased physical fitness is becoming more common in later adulthood, a group in whom there may be even more diagnostic difficulty.We hypothesized that tissue characterization using cardiovascular magnetic resonance (CMR) T1 and T2 mapping would be able to differentiate between patients with left ventricular (LV) dilatation due to early DCM and exercisers. Methods and results Fifty-eight middle-aged males [21 healthy controls, 21 males with a history of aerobic exercise and LV ejection fraction (LVEF) 45-55%, and 16 patients with DCMand LVEF 45-55%] underwent a CMR protocol including T1 and T2 mapping and calculation of extracellular volume (ECV) using a 1.5 T MRI scanner. Native T1, ECV, and T2 relaxation times were significantly increased in DCM patients compared with controls (native T1 1017±42 vs. 952±31 ms, P < 0.001; ECV 31.2±4.1 vs. 26.2±2.9%, P = 0.003; T2 55.9±4.4 vs. 52.9±3.3 ms, P = 0.05) and exercisers (native T1 957±32 ms, P < 0.001; ECV 26.3±3.6%, P = 0.004; T2 52.8±3.2 ms, P = 0.042). Using multivariable logistic regression, native T1 gave the best differentiation between exercisers and sedentary patients with early DCM (area under the curve 0.91). Conclusion T1 and T2 mapping are potentially useful tools for differentiating between athlete's heart and patients with early DCM, and could be used whenever differentiation between these two phenotypes is inconclusive using standard imaging techniques. Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2015.

KW - Athletes

KW - Cardiovascular magnetic resonance

KW - Dilated cardiomyopathy

KW - T mapping

UR - http://www.scopus.com/inward/record.url?scp=84988908259&partnerID=8YFLogxK

U2 - 10.1093/ehjci/jev216

DO - 10.1093/ehjci/jev216

M3 - Article

VL - 17

SP - 797

EP - 803

JO - European Heart Journal - Cardiovascular Imaging

JF - European Heart Journal - Cardiovascular Imaging

SN - 2047-2404

IS - 7

ER -