CMR-verified diffuse myocardial fibrosis is associated with diastolic dysfunction in HFpEF

Mao Yuan M. Su, Lian Yu Lin, Yao Hui E. Tseng, Chin Chen Chang, Cho Kai Wu, Jiunn Lee Lin, Wen Yih I. Tseng

研究成果: 雜誌貢獻文章

84 引文 (Scopus)

摘要

OBJECTIVES The purpose of this study was to investigate diffuse myocardial fibrosis in patients with systolic heart failure (SHF) and in patients with heart failure with preserved ejection fraction (HFpEF) and the association with diastolic dysfunction of the left ventricle (LV). 2014 American College of Cardiology Foundation. BACKGROUND Increased diffuse myocardial fibrosis may impair LV diastolic function. However, no study has verified the association between the degree of diffuse myocardial fibrosis and the severity of impaired diastolic function in SHF and HFpEF. METHODS Forty patients with SHF, 62 patients with HFpEF, and 22 patients without HF underwent cardiac magnetic resonance (CMR), including T1 mapping and cine CMR on a 3-T system. Extracellular volume fraction (ECV), a measure of diffuse myocardial fibrosis, was quantified from T1 mapping. Systolic and diastolic functions of the LV were assessed by cine CMR. The ECV values and LV functional indexes were compared among the 3 groups. Associations between ECV and LV diastolic function were also investigated. RESULTS Compared with patients without HF, significantly higher ECV was found in patients with SHF (31.2% [interquartile range (IQR): 29.0% to 34.1%] vs. 27.9% [IQR: 26.2% to 29.4%], p <0.001) and HFpEF (28.9% [IQR: 27.8% to 31.3%] vs. 27.9% [IQR: 26.2% to 29.4%], p = 0.006). Peak filling rate, a diastolic functional index assessed by cine CMR, was significantly decreased in patients with SHF (1.00 s-1 [IQR: 0.79 to 1.49 s-1] vs. 3.86 s-1 [IQR: 3.34 to 4.48 s-1], p <0.001) and HFpEF (2.89 s-1 [IQR: 2.13 to 3.50 s-1] vs. 3.86 s-1 [IQR: 3.34 to 4.48 s-1], p <0.001). Myocardial ECV was significantly correlated with peak filling rate in the HFpEF group (r = -0.385, p = 0.002), but no correlation was found in the SHF and non-HF groups (r = 0.030, p = 0.856 and r = -0.238, p = 0.285, respectively). CONCLUSIONS In patients with HF, only those with HFpEF show a significant correlation between increased diffuse myocardial fibrosis and impaired diastolic function. Diffuse myocardial fibrosis plays a unique role in the pathogenesis of HFpEF. (J Am Coll Cardiol Img 2014;7:991-7).
原文英語
頁(從 - 到)991-997
頁數7
期刊JACC: Cardiovascular Imaging
7
發行號10
DOIs
出版狀態已發佈 - 一月 1 2014
對外發佈Yes

指紋

Systolic Heart Failure
Fibrosis
Magnetic Resonance Spectroscopy
Heart Failure
Heart Ventricles

Keywords

  • cardiac magnetic resonance
  • extracellular volume fraction
  • heart failure with preserved ejection fraction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

引用此文

CMR-verified diffuse myocardial fibrosis is associated with diastolic dysfunction in HFpEF. / Su, Mao Yuan M.; Lin, Lian Yu; Tseng, Yao Hui E.; Chang, Chin Chen; Wu, Cho Kai; Lin, Jiunn Lee; Tseng, Wen Yih I.

於: JACC: Cardiovascular Imaging, 卷 7, 編號 10, 01.01.2014, p. 991-997.

研究成果: 雜誌貢獻文章

Su, Mao Yuan M. ; Lin, Lian Yu ; Tseng, Yao Hui E. ; Chang, Chin Chen ; Wu, Cho Kai ; Lin, Jiunn Lee ; Tseng, Wen Yih I. / CMR-verified diffuse myocardial fibrosis is associated with diastolic dysfunction in HFpEF. 於: JACC: Cardiovascular Imaging. 2014 ; 卷 7, 編號 10. 頁 991-997.
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title = "CMR-verified diffuse myocardial fibrosis is associated with diastolic dysfunction in HFpEF",
abstract = "OBJECTIVES The purpose of this study was to investigate diffuse myocardial fibrosis in patients with systolic heart failure (SHF) and in patients with heart failure with preserved ejection fraction (HFpEF) and the association with diastolic dysfunction of the left ventricle (LV). 2014 American College of Cardiology Foundation.BACKGROUND Increased diffuse myocardial fibrosis may impair LV diastolic function. However, no study has verified the association between the degree of diffuse myocardial fibrosis and the severity of impaired diastolic function in SHF and HFpEF.METHODS Forty patients with SHF, 62 patients with HFpEF, and 22 patients without HF underwent cardiac magnetic resonance (CMR), including T1 mapping and cine CMR on a 3-T system. Extracellular volume fraction (ECV), a measure of diffuse myocardial fibrosis, was quantified from T1 mapping. Systolic and diastolic functions of the LV were assessed by cine CMR. The ECV values and LV functional indexes were compared among the 3 groups. Associations between ECV and LV diastolic function were also investigated.RESULTS Compared with patients without HF, significantly higher ECV was found in patients with SHF (31.2{\%} [interquartile range (IQR): 29.0{\%} to 34.1{\%}] vs. 27.9{\%} [IQR: 26.2{\%} to 29.4{\%}], p <0.001) and HFpEF (28.9{\%} [IQR: 27.8{\%} to 31.3{\%}] vs. 27.9{\%} [IQR: 26.2{\%} to 29.4{\%}], p = 0.006). Peak filling rate, a diastolic functional index assessed by cine CMR, was significantly decreased in patients with SHF (1.00 s-1 [IQR: 0.79 to 1.49 s-1] vs. 3.86 s-1 [IQR: 3.34 to 4.48 s-1], p <0.001) and HFpEF (2.89 s-1 [IQR: 2.13 to 3.50 s-1] vs. 3.86 s-1 [IQR: 3.34 to 4.48 s-1], p <0.001). Myocardial ECV was significantly correlated with peak filling rate in the HFpEF group (r = -0.385, p = 0.002), but no correlation was found in the SHF and non-HF groups (r = 0.030, p = 0.856 and r = -0.238, p = 0.285, respectively).CONCLUSIONS In patients with HF, only those with HFpEF show a significant correlation between increased diffuse myocardial fibrosis and impaired diastolic function. Diffuse myocardial fibrosis plays a unique role in the pathogenesis of HFpEF. (J Am Coll Cardiol Img 2014;7:991-7).",
keywords = "cardiac magnetic resonance, extracellular volume fraction, heart failure with preserved ejection fraction, cardiac magnetic resonance, extracellular volume fraction, heart failure with preserved ejection fraction",
author = "Su, {Mao Yuan M.} and Lin, {Lian Yu} and Tseng, {Yao Hui E.} and Chang, {Chin Chen} and Wu, {Cho Kai} and Lin, {Jiunn Lee} and Tseng, {Wen Yih I.}",
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TY - JOUR

T1 - CMR-verified diffuse myocardial fibrosis is associated with diastolic dysfunction in HFpEF

AU - Su, Mao Yuan M.

AU - Lin, Lian Yu

AU - Tseng, Yao Hui E.

AU - Chang, Chin Chen

AU - Wu, Cho Kai

AU - Lin, Jiunn Lee

AU - Tseng, Wen Yih I.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - OBJECTIVES The purpose of this study was to investigate diffuse myocardial fibrosis in patients with systolic heart failure (SHF) and in patients with heart failure with preserved ejection fraction (HFpEF) and the association with diastolic dysfunction of the left ventricle (LV). 2014 American College of Cardiology Foundation.BACKGROUND Increased diffuse myocardial fibrosis may impair LV diastolic function. However, no study has verified the association between the degree of diffuse myocardial fibrosis and the severity of impaired diastolic function in SHF and HFpEF.METHODS Forty patients with SHF, 62 patients with HFpEF, and 22 patients without HF underwent cardiac magnetic resonance (CMR), including T1 mapping and cine CMR on a 3-T system. Extracellular volume fraction (ECV), a measure of diffuse myocardial fibrosis, was quantified from T1 mapping. Systolic and diastolic functions of the LV were assessed by cine CMR. The ECV values and LV functional indexes were compared among the 3 groups. Associations between ECV and LV diastolic function were also investigated.RESULTS Compared with patients without HF, significantly higher ECV was found in patients with SHF (31.2% [interquartile range (IQR): 29.0% to 34.1%] vs. 27.9% [IQR: 26.2% to 29.4%], p <0.001) and HFpEF (28.9% [IQR: 27.8% to 31.3%] vs. 27.9% [IQR: 26.2% to 29.4%], p = 0.006). Peak filling rate, a diastolic functional index assessed by cine CMR, was significantly decreased in patients with SHF (1.00 s-1 [IQR: 0.79 to 1.49 s-1] vs. 3.86 s-1 [IQR: 3.34 to 4.48 s-1], p <0.001) and HFpEF (2.89 s-1 [IQR: 2.13 to 3.50 s-1] vs. 3.86 s-1 [IQR: 3.34 to 4.48 s-1], p <0.001). Myocardial ECV was significantly correlated with peak filling rate in the HFpEF group (r = -0.385, p = 0.002), but no correlation was found in the SHF and non-HF groups (r = 0.030, p = 0.856 and r = -0.238, p = 0.285, respectively).CONCLUSIONS In patients with HF, only those with HFpEF show a significant correlation between increased diffuse myocardial fibrosis and impaired diastolic function. Diffuse myocardial fibrosis plays a unique role in the pathogenesis of HFpEF. (J Am Coll Cardiol Img 2014;7:991-7).

AB - OBJECTIVES The purpose of this study was to investigate diffuse myocardial fibrosis in patients with systolic heart failure (SHF) and in patients with heart failure with preserved ejection fraction (HFpEF) and the association with diastolic dysfunction of the left ventricle (LV). 2014 American College of Cardiology Foundation.BACKGROUND Increased diffuse myocardial fibrosis may impair LV diastolic function. However, no study has verified the association between the degree of diffuse myocardial fibrosis and the severity of impaired diastolic function in SHF and HFpEF.METHODS Forty patients with SHF, 62 patients with HFpEF, and 22 patients without HF underwent cardiac magnetic resonance (CMR), including T1 mapping and cine CMR on a 3-T system. Extracellular volume fraction (ECV), a measure of diffuse myocardial fibrosis, was quantified from T1 mapping. Systolic and diastolic functions of the LV were assessed by cine CMR. The ECV values and LV functional indexes were compared among the 3 groups. Associations between ECV and LV diastolic function were also investigated.RESULTS Compared with patients without HF, significantly higher ECV was found in patients with SHF (31.2% [interquartile range (IQR): 29.0% to 34.1%] vs. 27.9% [IQR: 26.2% to 29.4%], p <0.001) and HFpEF (28.9% [IQR: 27.8% to 31.3%] vs. 27.9% [IQR: 26.2% to 29.4%], p = 0.006). Peak filling rate, a diastolic functional index assessed by cine CMR, was significantly decreased in patients with SHF (1.00 s-1 [IQR: 0.79 to 1.49 s-1] vs. 3.86 s-1 [IQR: 3.34 to 4.48 s-1], p <0.001) and HFpEF (2.89 s-1 [IQR: 2.13 to 3.50 s-1] vs. 3.86 s-1 [IQR: 3.34 to 4.48 s-1], p <0.001). Myocardial ECV was significantly correlated with peak filling rate in the HFpEF group (r = -0.385, p = 0.002), but no correlation was found in the SHF and non-HF groups (r = 0.030, p = 0.856 and r = -0.238, p = 0.285, respectively).CONCLUSIONS In patients with HF, only those with HFpEF show a significant correlation between increased diffuse myocardial fibrosis and impaired diastolic function. Diffuse myocardial fibrosis plays a unique role in the pathogenesis of HFpEF. (J Am Coll Cardiol Img 2014;7:991-7).

KW - cardiac magnetic resonance

KW - extracellular volume fraction

KW - heart failure with preserved ejection fraction

KW - cardiac magnetic resonance

KW - extracellular volume fraction

KW - heart failure with preserved ejection fraction

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U2 - 10.1016/j.jcmg.2014.04.022

DO - 10.1016/j.jcmg.2014.04.022

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