Native myocardial T1 mapping in pulmonary hypertension: correlations with cardiac function and hemodynamics

Objectives

To analyze alterations in left ventricular (LV) myocardial T1 times in patients with pulmonary hypertension (PH) and to investigate their associations with ventricular function, mass, geometry and hemodynamics.

Methods

Fifty-eight patients with suspected PH underwent right heart catheterization (RHC) and 3T cardiac magnetic resonance imaging. Ventricular function, geometry and mass were derived from cine real-time short-axis images. Myocardial T1 maps were acquired by a prototype modified Look-Locker inversion-recovery sequence in short-axis orientations. LV global, segmental and ventricular insertion point (VIP) T1 times were evaluated manually and corrected for blood T1.

Results

Septal, lateral, global and VIP T1 times were significantly higher in PH than in non-PH subjects (septal, 1249?±?58 ms vs. 1186?±?33 ms, p?<?0.0001; lateral, 1190?±?45 ms vs. 1150?±?33 ms, p?=?0.0003; global, 1220?±?52 ms vs. 1171?±?29 ms, p?<?0.0001; VIP, 1298?±?78 ms vs. 1193?±?31 ms, p?<?0.0001). In PH, LV eccentricity index was the strongest linear predictor of VIP T1 (r?=?0.72). Septal, lateral and global T1 showed strong correlations with VIP T1 (r?=?0.81, r?=?0.59 and r?=?0.75, respectively).

Conclusions

In patients with PH, T1 times in VIPs and in the entire LV myocardium are elevated. LV eccentricity strongly correlates with VIP T1 time, which in turn is strongly associated with T1 time changes in the entire LV myocardium.

Key Points

? Native T1 mapping detects left ventricular myocardial alterations in pulmonary hypertension ? In pulmonary hypertension, native T1 times at ventricular insertion points are increased ? These T1 times correlate strongly with left ventricular eccentricity ? In pulmonary hypertension, global and segmental myocardial T1 times are increased ? Global, segmental and ventricular insertion point T1 times are strongly correlated