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- Title
Reproducibility of in-vivo diffusion tensor cardiovascular magnetic resonance in hypertrophic cardiomyopathy.
- Authors
McGill, Laura-Ann; Ismail, Tevfik F.; Nielles-Vallespin, Sonia; Ferreira, Pedro; Scott, Andrew D.; Roughton, Michael; Kilner, Philip J.; S. Yen Ho; McCarthy, Karen P.; Gatehouse, Peter D.; de Silva, Ranil; Speier, Peter; Feiweier, Thorsten; Mekkaoui, Choukkri; Sosnovik, David E.; Prasad, Sanjay K.; Firmin, David N.; Pennell, Dudley J.
- Abstract
Background: Myocardial disarray is an important histological feature of hypertrophic cardiomyopathy (HCM) which has been studied post-mortem, but its in-vivo prevalence and extent is unknown. Cardiac Diffusion Tensor Imaging (cDTI) provides information on mean intravoxel myocyte orientation and potentially myocardial disarray. Recent technical advances have improved in-vivo cDTI, and the aim of this study was to assess the interstudy reproducibility of quantitative in-vivo cDTI in patients with HCM. Methods and results: A stimulated-echo single-shot-EPI sequence with zonal excitation and parallel imaging was implemented. Ten patients with HCM were each scanned on 2 different days. For each scan 3 short axis mid-ventricular slices were acquired with cDTI at end systole. Fractional anisotropy (FA), mean diffusivity (MD), and helix angle (HA) maps were created using a cDTI post-processing platform developed in-house. The mean ± SD global FA was 0.613 ± 0.044, MD was 0.750 ± 0.154 × 10-3 mm2/s and HA was epicardium -34.3 ± 7.6°, mesocardium 3.5 ± 6.9° and endocardium 38.9 ± 8.1°. Comparison of initial and repeat studies showed global interstudy reproducibility for FA (SD = ± 0.045, Coefficient of Variation (CoV) = 7.2%), MD (SD = ± 0.135 × 10-3 mm2/s, CoV = 18.6%) and HA (epicardium SD = ± 4.8°; mesocardium SD = ± 3.4°; endocardium SD = ± 2.9°). Reproducibility of FA was superior to MD (p = 0.003). Global MD was significantly higher in the septum than the reference lateral wall (0.784 ± 0.188 vs 0.750 ± 0.154 x10-3 mm2/s, p < 0.001). Septal HA was significantly lower than the reference lateral wall in all 3 transmural layers (from -8.3° to -10.4°, all p < 0.001). Conclusions: To the best of our knowledge, this is the first study to assess the interstudy reproducibility of DTI in the human HCM heart in-vivo and the largest cDTI study in HCM to date. Our results show good reproducibility of FA, MD and HA which indicates that current technology yields robust in-vivo measurements that have potential clinical value. The interpretation of regional differences in the septum requires further investigation.
- Subjects
CARDIOMYOPATHIES; HEART diseases; MUSCLE cells; CELLS; CARDIOVASCULAR diseases; ENDOCARDIUM; CARDIAC hypertrophy; HEART septum; MAGNETIC resonance imaging; PERICARDIUM; RESEARCH evaluation; DESCRIPTIVE statistics
- Publication
Journal of Cardiovascular Magnetic Resonance (BioMed Central), 2012, Vol 14, Issue 1, p86
- ISSN
1532-429X
- Publication type
Article
- DOI
10.1186/1532-429X-14-86