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Journal of Cardiovascular Magnetic Resonance

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Open Access 01-01-2017 | Research

Histologic validation of myocardial fibrosis measured by T1 mapping: a systematic review and meta-analysis

Authors: Kai-yue Diao, Zhi-gang Yang, Hua-yan Xu, Xi Liu, Qin Zhang, Ke Shi, Li Jiang, Lin-jun Xie, Ling-yi Wen, Ying-kun Guo

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2017

Abstract

Background

Myocardial fibrosis is being increasingly recognised as a common final pathway of a wide range of diseases. Thus, the development of an accurate and convenient method to evaluate myocardial fibrosis is of major importance. Although T1 mapping is a potential alternative for myocardial biopsy, validation studies are limited to small numbers and vary regarding technical facets, and include only a restricted number of disease. A systematic review and meta-analysis was conducted to objectively and comprehensively evaluate the performance of T1 mapping on the quantification of myocardial fibrosis using cardiovascular magnetic resonance (CMR).

Methods

PubMed, EMBASE and the Cochrane Library databases were searched for studies applying T1 mapping to measure myocardial fibrosis and that validated the results via histological analysis. A pooled correlation coefficient between the CMR and histology measurements was used to evaluate the performance of the T1 mapping.

Results

A total of 15 studies, including 308 patients who had CMR and myocardial biopsy were included and the pooled correlation coefficient between ECV measured by T1 mapping and biopsy for the selected studies was 0.884 (95% CI: 0.854, 0.914) and was not notably heterogeneous chi-squared = 7.44; P = 0.489 for the Q test and I^2 = 0.00%).

Conclusions

The quantitative measurement of myocardial fibrosis via T1 mapping is associated with a favourable overall correlation with the myocardial biopsy measurements. Further studies are required to determine the calibration of the T1 mapping results for the biopsy findings of different cardiomyopathies.

Karamitsos TD, Francis JM, Myerson S, Selvanayagam JB, Neubauer S. The Role of Cardiovascular Magnetic Resonance Imaging in Heart Failure. Jac. 2009;54:1407–24.

Bohl S, Wassmuth R, Abdel-Aty H, Rudolph A, Messroghli D, Dietz R, Schulz-Menger J. Delayed enhancement cardiac magnetic resonance imaging reveals typical patterns of myocardial injury in patients with various forms of non-ischemic heart disease. Int J Cardiovasc Imaging. 2008;24:597–607.CrossRefPubMed

Jellis CL, Kwon DH. Myocardial T1 mapping: modalities and clinical applications. Cardiovasc Diagn Ther [Internet]. 2014;4:126–37. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3996234&tool=pmcentrez&rendertype=abstract.

Dweck MR, Joshi S, Murigu T, Alpendurada F, Jabbour A, Melina G, Banya W, Gulati A, Roussin I, Raza S, Prasad NA, Wage R, Quarto C, Angeloni E, Refice S, Sheppard M, Cook SA, Kilner PJ, Pennell DJ, Newby DE, Mohiaddin RH, Pepper J, Prasad SK. Midwall fibrosis is an independent predictor of mortality in patients with aortic stenosis. J Am Coll Cardiol [Internet]. 2011;58:1271–9. Available from: http://dx.doi.org/10.1016/j.jacc.2011.03.064.CrossRef

O’Hanlon R, Grasso A, Roughton M, Moon JC, Clark S, Wage R, Webb J, Kulkarni M, Dawson D, Sulaibeekh L, Chandrasekaran B, Bucciarelli-Ducci C, Pasquale F, Cowie MR, McKenna WJ, Sheppard MN, Elliott PM, Pennell DJ, Prasad SK. Prognostic significance of myocardial fibrosis in hypertrophic cardiomyopathy. J Am Coll Cardiol [Internet]. 2010;56:867–74. Available from: http://dx.doi.org/10.1016/j.jacc.2010.05.010.CrossRef

Azevedo CF, Nigri M, Higuchi ML, Pomerantzeff PM, Spina GS, Sampaio RO, Tarasoutchi F, Grinberg M, Rochitte CE. Prognostic significance of myocardial fibrosis quantification by histopathology and magnetic resonance imaging in patients with severe aortic valve disease. J Am Coll Cardiol [Internet]. 2010;56:278–87. Available from: http://dx.doi.org/10.1016/j.jacc.2009.12.074.CrossRef

Mewton N, Liu CY, Croisille P, Bluemke D, Lima JAC. Assessment of myocardial fibrosis with cardiovascular magnetic resonance. J Am Coll Cardiol [Internet]. 2011;57:891–903. Available from: http://dx.doi.org/10.1016/j.jacc.2010.11.013.CrossRef

Cooper LT, Baughman KL, Feldman a. M, Frustaci a., Jessup M, Kuhl U, Levine GN, Narula J, Starling RC, Towbin J, Virmani R. The role of endomyocardial biopsy in the management of cardiovascular disease: A Scientific Statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology Endorsed by the Heart Failure Society of.Eur Heart J [Internet]. 2007;28:3076–3093. Available from: http://eurheartj.oxfordjournals.org/cgi/doi/10.1093/eurheartj/ehm456

Bulluck H, Maestrini V, Rosmini S. Myocardial T1 Mapping : Hope or Hype?[J]. Circulation J Official J Japanese Circulation Soc. 2015;79:487–94.

10.

Burt JR, Zimmerman SL, Kamel IR, Halushka M, Bluemke DA. Myocardial T1 Mapping : Techniques. 2014.

11.

Moon JC, Messroghli DR, Kellman P, Piechnik SK, Robson MD, Ugander M, Gatehouse PD, Arai AE, Friedrich MG, Neubauer S, Schulz-Menger J, Schelbert EB. Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement. J Cardiovasc Magn Reson [Internet]. 2013;15:92. Available from: http://jcmr-online.biomedcentral.com/articles/10.1186/1532-429X-15-92.CrossRef

12.

Lee JJ, Liu S, Nacif MS, Ugander M, Han J, Kawel N, Sibley CT, Kellman P, Arai AE, Bluemke DA. Myocardial T1 and extracellular volume fraction mapping at 3 tesla. J Cardiovasc Magn Reson [Internet]. 2011;13:75. Available from: http://www.jcmr-online.com/content/13/1/75.CrossRef

13.

Nacif MS, Turkbey EB, Gai N, Ugander M, Liu S, Arai AE, Lima JAC. NIH Public Access. 2012;34:1367–73.

14.

Raman FS, Kawel-Boehm N, Gai N, Freed M, Han J, Liu C-Y, Lima JAC, Bluemke DA, Liu S. Modified look-locker inversion recovery T1 mapping indices: assessment of accuracy and reproducibility between magnetic resonance scanners. J Cardiovasc Magn Reson [Internet]. 2013;15:64. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid = 3733695&tool = pmcentrez&rendertype = abstract.CrossRef

15.

Roujol S, Weingärtner S, Foppa M, Chow K, Kawaji K, Ngo LH, Kellman P, Manning WJ, Thompson RB, Nezafat R. Accuracy, precision, and reproducibility of four T1 mapping sequences: a head-to-head comparison of MOLLI, ShMOLLI, SASHA, and SAPPHIRE. Radiology [Internet]. 2014;272:683–9. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4263641&tool=pmcentrez&rendertype=abstract.CrossRef

16.

Whiting PF, Weswood ME, Rutjes AW, et al. Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies [J]. Bmc Med Res Methodol. 2006;6(1):1–8.

17.

Whiting P, Rutjes AWS, Reitsma JB, Bossuyt PMM, Kleijnen J. The development of QUADAS : a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003;13:1–13.

18.

Whiting PF, Rutjes AWS, Westwood ME, Mallet S, Deeks JJ, Reitsma JB, Leeflang MMG, Sterne JAC, Bossuyt PMM. Research and Reporting Methods Accuracy Studies. Ann Intern Med. 2011;155:529–36.CrossRefPubMed

19.

Fisher RA. Frequency distribution of the values of the correlation coeffients in samples from an indefinitely large population. Biometrika. 1915;10(4)507–21.

20.

Goto Y, Ishida M, Nakamori S, et al. Native T1 mapping in patients with idiopathic dilated cardiomyopathy for the assessment of diffuse myocardial fibrosis: validation against histologic endomyocardial biopsy [J]. J Cardiovasc Magnetic Reson. 2015;17(1):1–2.

21.

De Meester de Ravenstein C, Bouzin C, Lazam S, Boulif J, Amzulescu M, Melchior J, Pasquet A, Vancraeynest D, Pouleur AC, Vanoverschelde JLJ, Gerber BL. Histological Validation of measurement of diffuse interstitial myocardial fibrosis by myocardial extravascular volume fraction from Modified Look-Locker imaging (MOLLI) T1 mapping at 3 T. J Cardiovasc Magn Reson [Internet]. 2015;17:48. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid = 4464705&tool = pmcentrez&rendertype = abstract.CrossRef

22.

Miller CA, Naish JH, Bishop P, Coutts G, Clark D, Zhao S, Ray SG, Yonan N, Williams SG, Flett AS, Moon JC, Greiser A, Parker GJM, Schmitt M. Comprehensive validation of cardiovascular magnetic resonance techniques for the assessment of myocardial extracellular volume. Circ Cardiovasc Imaging. 2013;6:373–83.CrossRefPubMed

23.

Mascherbauer J, Marzluf BA, Tufaro C, Pfaffenberger S, Graf A, Wexberg P, Panzenböck A, Jakowitsch J, Bangert C, Laimer D, Schreiber C, Karakus G, Hülsmann M, Pacher R, Lang IM, Maurer G, Bonderman D. Cardiac magnetic resonance postcontrast T1 time is associated with outcome in patients with heart failure and preserved ejection fraction. Circ Cardiovasc Imaging. 2013;6:1056–65.CrossRefPubMed

24.

White SK, Sado DM, Fontana M, Banypersad SM, Maestrini V, Flett AS, Piechnik SK, Robson MD, Hausenloy DJ, Sheikh AM, Hawkins PN, Moon JC. T1 Mapping for Myocardial Extracellular Volume Measurement by CMR. JACC Cardiovasc Imaging [Internet]. 2013;6:955–62. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1936878X13002295.CrossRef

25.

Iles L, Pfluger H, Phrommintikul A, et al. Evaluation of diffuse myocardial fibrosis in heart failure with cardiac magnetic resonance contrast-enhanced T1 mapping [J]. J Am College Cardiol. 2008; 52(19):1574–80.

26.

Fontana M, White SK, Banypersad SM, Sado DM, Maestrini V, Flett AS, Piechnik SK, Neubauer S, Roberts N, Moon JC. Comparison of T1 mapping techniques for ECV quantification. Histological validation and reproducibility of ShMOLLI versus multibreath-hold T1 quantification equilibrium contrast CMR. J Cardiovasc Magn Reson [Internet]. 2012;14:88. Available from: Journal of Cardiovascular Magnetic Resonance.CrossRef

27.

White SK, Piechnik SK, Neubauer S, Robson MD, Moon J. Histological validation of ShMOLLI equilibrium contrast CMR for the measurement of diffuse myocardial fibrosis. J Cardiovasc Magn Reson [Internet]. 2012;14:O111. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22375734.CrossRef

28.

Flett AS, Hayward MP, Ashworth MT, Hansen MS, Taylor AM, Elliott PM, McGregor C, Moon JC. Equilibrium Contrast Cardiovascular Magnetic Resonance for the Measurement of Diffuse Myocardial Fibrosis: Preliminary Validation in Humans. Circulation [Internet]. 2010;122:138–44. Available from: http://circ.ahajournals.org/cgi/doi/10.1161/CIRCULATIONAHA.109.930636.CrossRef

29.

Martos R, Baugh J, Ledwidge M, Loughlin CO, Conlon C, Patle A, Donnelly SC, Mcdonald K. Evidence of Increased Myocardial Collagen Turnover Linked to Diastolic Dysfunction. 2007.

30.

Disease HH, Etayo JC, Martı L, Gutierrez-stampa M, Emparanza I, Gil J, Monreal I, Minda JP, Dı J. Serum Carboxy-Terminal Propeptide of Procollagen Type I Is a Marker of Myocardial Fibrosis in. 2000.

31.

Jellis C, Martin J, Narula J, Marwick TH. Assessment of Nonischemic Myocardial Fibrosis. JAC [Internet]. 2010;56:89–97. Available from: http://dx.doi.org/10.1016/j.jacc.2010.02.047.

32.

Pennell DJ, Sechtem UP, Higgins CB, Manning WJ, Pohost GM, Rademakers FE, Van Rossum AC, Shaw LJ, Yucel EK. Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report. Eur Heart J. 2004;25:1940–65.CrossRefPubMed

33.

Hunold P, Schlosser T, Vogt F M, et al. Myocardial late enhancement in contrast-enhanced cardiac MRI: distinction between infarction scar and non-infarction-related disease [J]. Am J Roentgenol. 2005;184(5):1420–6.

34.

Sado DM, Flett AS, Moon JC. Novel imaging techniques for diffuse myocardial fibrosis. Futur Cardiol. 2011;7:643–50.CrossRef

35.

Kammerlander A, Tufaro C, Bachmann AF, Marzluf BA, Aschauer S, Greiser A, Bonderman D, Mascherbauer J. Extracellular matrix expansion by cardiac magnetic resonance T1 mapping- validation with myocardial biopsy. J Cardiovasc Magn Reson [Internet]. 2015;17:P308. Available from: http://www.jcmr-online.com/content/17/S1/P308.CrossRef

36.

Sharma P, Socolow J, Patel S, Pettigrew RI, Oshinski JN. Effect of Gd-DTPA-BMA on blood and myocardial T1 at 1.5T and 3T in humans. J Magn Reson Imaging. 2006;23:323–30.CrossRefPubMed

37.

Aus dem Siepen F, Buss S, Andre F, Keller M, Seitz SA, Korosoglou G, Giannitsis E, Katus HA, Steen H. Extracellular volume assessed by CMR T1-mapping correlates with histologically determined amount of diffuse fibrosis in DCM. J Cardiovasc Magn Reson [Internet]. 2014;16:M8. Available from: http://www.jcmr-online.com/content/16/S1/M8.CrossRef

38.

Liberato G, Bello J, Melo RD, Assunção Jr AN, Pacheco AB, Soares BA, Nakamura DY, Demarchi L, Costa VE, Sampaio RO, Kalil R, Rochitte CE. Myocardial extracellular volume fraction and myocardial fibrosis by cmr in patients with severe aortic stenosis. J Cardiovasc Magn Reson [Internet]. 2015;17:P290. Available from: http://www.jcmr-online.com/content/17/S1/P290.CrossRef

39.

Duca F, Bachmann A, Knechtelsdorfer K, Wiesinger M, Pfaffenberger S, Greiser A, Lang IM, Bonderman D, Mascherbauer J. T1 Mapping by CMR Imaging. 2016;9:14–23.

40.

Iles LM, Ellims AH, HuwLlewellyn, et al. Histological validation of cardiac magnetic resonance analysis of regional and diffuse interstitial myocardial fibrosis [J]. Eur Heart J - Cardiovasc Imaging. 2015;16(1):14–22.

41.

Sibley CT, Noureldin RA, Gai N, Nacif MS, Liu S, Turkbey EB, Mudd JO, Van der Geest RJ, Lima JAC, Halushka MK, Bluemke DA. T1 Mapping in Cardiomyopathy at Cardiac MR: Comparison with Endomyocardial Biopsy. Radiology. 2012;265:724–32.CrossRefPubMedPubMedCentral

Title: Histologic validation of myocardial fibrosis measured by T1 mapping: a systematic review and meta-analysis
Authors: Kai-yue Diao
Zhi-gang Yang
Hua-yan Xu
Xi Liu
Qin Zhang
Ke Shi
Li Jiang
Lin-jun Xie
Ling-yi Wen
Ying-kun Guo
Publication date: 01-01-2017
Publisher: BioMed Central
Published in: Journal of Cardiovascular Magnetic Resonance / Issue 1/2017
Electronic ISSN: 1532-429X
DOI: https://doi.org/10.1186/s12968-016-0313-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Histologic validation of myocardial fibrosis measured by T1 mapping: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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