Detection of Early Diffuse Myocardial Fibrosis and Inflammation in Chagas Cardiomyopathy with T1 Mapping and Extracellular Volume.

Cardiac Chagas Cardiomyopathy Heart Imaging Sequences MRI

Journal

Radiology. Cardiothoracic imaging
ISSN: 2638-6135
Titre abrégé: Radiol Cardiothorac Imaging
Pays: United States
ID NLM: 101748663

Informations de publication

Date de publication:
Jun 2023
Historique:
received: 03 06 2022
revised: 06 02 2023
accepted: 17 04 2023
medline: 5 7 2023
pubmed: 5 7 2023
entrez: 5 7 2023
Statut: epublish

Résumé

To evaluate myocardial T1 mapping and extracellular volume (ECV) parameters in different stages of Chagas cardiomyopathy and determine whether they are predictive of disease severity and prognosis. Prospectively enrolled participants (July 2013 to September 2016) underwent cine and late gadolinium enhancement (LGE) cardiac MRI and T1 mapping with a precontrast (native) or postcontrast modified Look-Locker sequence. The native T1 and ECV values were measured among subgroups that were based on disease severity (indeterminate, Chagas cardiomyopathy with preserved ejection fraction [CCpEF], Chagas cardiomyopathy with midrange ejection fraction [CCmrEF], and Chagas cardiomyopathy with reduced ejection fraction [CCrEF]). Cox proportional hazards regression and the Akaike information criterion were used to determine predictors of major cardiovascular events (cardioverter defibrillator implant, heart transplant, or death). In 107 participants (90 participants with Chagas disease [mean age ± SD, 55 years ± 11; 49 men] and 17 age- and sex-matched control participants), the left ventricular (LV) ejection fraction and the extent of focal and diffuse or interstitial fibrosis were correlated with disease severity. Participants with CCmrEF and participants with CCrEF showed significantly higher global native T1 and ECV values than participants in the indeterminate, CCpEF, and control groups (T1: 1072 msec ± 34 and 1073 msec ± 63 vs 1010 msec ± 41, 1005 msec ± 69, and 999 msec ± 46; ECV: 35.5% ± 3.6 and 35.0% ± 5.4 vs 25.3% ± 3.5, 28.2% ± 4.9, and 25.2% ± 2.2; both Myocardial native T1 and ECV values were correlated with Chagas disease severity and may serve as markers of myocardial involvement in Chagas cardiomyopathy that precede LGE and LV dysfunction.

Identifiants

DOI: 10.1148/ryct.220112 PMID: 37404789 PMC: PMC10316290
pubmed: 37404789
doi: 10.1148/ryct.220112
pmc: PMC10316290
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e220112

Informations de copyright

© 2023 by the Radiological Society of North America, Inc.

Déclaration de conflit d'intérêts

Disclosures of conflicts of interest: R.J.L.M. No relevant relationships. A.N.A. No relevant relationships. T.C.M. No relevant relationships. C.H.N. No relevant relationships. M.I.S. No relevant relationships. M.M.F. No relevant relationships. F.J.A.R. No relevant relationships. F.F. No relevant relationships. B.M.I. No relevant relationships. C.M. No relevant relationships. C.E.R. Secretary-treasurer and board member of the Society for Cardiovascular Magnetic Resonance.

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Auteurs

Rodrigo J L Melo (RJL)

From the Cardiovascular Magnetic Resonance and Computed Tomography Sector (R.J.L.M., A.N.A., T.C.M., C.H.N., C.E.R.), Arrhythmia Unit (M.I.S.), Artificial Cardiac Stimulation Unit (M.M.F.), and Cardiomyopathy Unit (F.J.A.R., F.F., B.M.I., C.M.), Heart Institute (Instituto do Coração), University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar 44, Andar AB, Cerqueira Cesar, São Paulo 05403-000 SP, Brazil.
ORCID: 0000-0002-2884-1712

Antonildes N Assunção (AN)

From the Cardiovascular Magnetic Resonance and Computed Tomography Sector (R.J.L.M., A.N.A., T.C.M., C.H.N., C.E.R.), Arrhythmia Unit (M.I.S.), Artificial Cardiac Stimulation Unit (M.M.F.), and Cardiomyopathy Unit (F.J.A.R., F.F., B.M.I., C.M.), Heart Institute (Instituto do Coração), University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar 44, Andar AB, Cerqueira Cesar, São Paulo 05403-000 SP, Brazil.
ORCID: 0000-0002-2567-017X

Thamara C Morais (TC)

From the Cardiovascular Magnetic Resonance and Computed Tomography Sector (R.J.L.M., A.N.A., T.C.M., C.H.N., C.E.R.), Arrhythmia Unit (M.I.S.), Artificial Cardiac Stimulation Unit (M.M.F.), and Cardiomyopathy Unit (F.J.A.R., F.F., B.M.I., C.M.), Heart Institute (Instituto do Coração), University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar 44, Andar AB, Cerqueira Cesar, São Paulo 05403-000 SP, Brazil.

Cesar H Nomura (CH)

From the Cardiovascular Magnetic Resonance and Computed Tomography Sector (R.J.L.M., A.N.A., T.C.M., C.H.N., C.E.R.), Arrhythmia Unit (M.I.S.), Artificial Cardiac Stimulation Unit (M.M.F.), and Cardiomyopathy Unit (F.J.A.R., F.F., B.M.I., C.M.), Heart Institute (Instituto do Coração), University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar 44, Andar AB, Cerqueira Cesar, São Paulo 05403-000 SP, Brazil.
ORCID: 0000-0002-7131-6614

Mauricio I Scanavacca (MI)

From the Cardiovascular Magnetic Resonance and Computed Tomography Sector (R.J.L.M., A.N.A., T.C.M., C.H.N., C.E.R.), Arrhythmia Unit (M.I.S.), Artificial Cardiac Stimulation Unit (M.M.F.), and Cardiomyopathy Unit (F.J.A.R., F.F., B.M.I., C.M.), Heart Institute (Instituto do Coração), University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar 44, Andar AB, Cerqueira Cesar, São Paulo 05403-000 SP, Brazil.

Martino Martinelli-Filho (M)

From the Cardiovascular Magnetic Resonance and Computed Tomography Sector (R.J.L.M., A.N.A., T.C.M., C.H.N., C.E.R.), Arrhythmia Unit (M.I.S.), Artificial Cardiac Stimulation Unit (M.M.F.), and Cardiomyopathy Unit (F.J.A.R., F.F., B.M.I., C.M.), Heart Institute (Instituto do Coração), University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar 44, Andar AB, Cerqueira Cesar, São Paulo 05403-000 SP, Brazil.

Felix J A Ramires (FJA)

From the Cardiovascular Magnetic Resonance and Computed Tomography Sector (R.J.L.M., A.N.A., T.C.M., C.H.N., C.E.R.), Arrhythmia Unit (M.I.S.), Artificial Cardiac Stimulation Unit (M.M.F.), and Cardiomyopathy Unit (F.J.A.R., F.F., B.M.I., C.M.), Heart Institute (Instituto do Coração), University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar 44, Andar AB, Cerqueira Cesar, São Paulo 05403-000 SP, Brazil.

Fabio Fernandes (F)

From the Cardiovascular Magnetic Resonance and Computed Tomography Sector (R.J.L.M., A.N.A., T.C.M., C.H.N., C.E.R.), Arrhythmia Unit (M.I.S.), Artificial Cardiac Stimulation Unit (M.M.F.), and Cardiomyopathy Unit (F.J.A.R., F.F., B.M.I., C.M.), Heart Institute (Instituto do Coração), University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar 44, Andar AB, Cerqueira Cesar, São Paulo 05403-000 SP, Brazil.

Barbara M Ianni (BM)

From the Cardiovascular Magnetic Resonance and Computed Tomography Sector (R.J.L.M., A.N.A., T.C.M., C.H.N., C.E.R.), Arrhythmia Unit (M.I.S.), Artificial Cardiac Stimulation Unit (M.M.F.), and Cardiomyopathy Unit (F.J.A.R., F.F., B.M.I., C.M.), Heart Institute (Instituto do Coração), University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar 44, Andar AB, Cerqueira Cesar, São Paulo 05403-000 SP, Brazil.

Charles Mady (C)

From the Cardiovascular Magnetic Resonance and Computed Tomography Sector (R.J.L.M., A.N.A., T.C.M., C.H.N., C.E.R.), Arrhythmia Unit (M.I.S.), Artificial Cardiac Stimulation Unit (M.M.F.), and Cardiomyopathy Unit (F.J.A.R., F.F., B.M.I., C.M.), Heart Institute (Instituto do Coração), University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar 44, Andar AB, Cerqueira Cesar, São Paulo 05403-000 SP, Brazil.

Carlos E Rochitte (CE)

From the Cardiovascular Magnetic Resonance and Computed Tomography Sector (R.J.L.M., A.N.A., T.C.M., C.H.N., C.E.R.), Arrhythmia Unit (M.I.S.), Artificial Cardiac Stimulation Unit (M.M.F.), and Cardiomyopathy Unit (F.J.A.R., F.F., B.M.I., C.M.), Heart Institute (Instituto do Coração), University of São Paulo Medical School, Av Dr Enéas de Carvalho Aguiar 44, Andar AB, Cerqueira Cesar, São Paulo 05403-000 SP, Brazil.
ORCID: 0000-0003-4505-3344

Classifications MeSH