Myocardial Partition Coefficient of Gadolinium: A Pilot Study in Patients With Acute Myocarditis,Chronic Myocardial Infarction,and in Healthy Volunteers |
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Authors: | Tiago Teixeira Tarik Hafyane Michael Jerosch-Herold François Marcotte François-Pierre Mongeon |
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Affiliation: | 1. Philippa & Marvin Carsley CMR Center, Montréal Heart Institute, Université de Montréal, Montréal, Québec, Canada;2. Centro Hospitalar entre Douro e Vouga, Sta Maria da Feira, Portugal;3. Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts |
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Abstract: | BackgroundThe tissue-blood partition coefficient (PC) of gadolinium, derived from T1 measurements, reflects myocardial connective tissue fraction and tissue injury, increasing in proportion with edema or fibrosis. We determined the myocardial PC of gadolinium in patients with acute myocarditis, chronic myocardial infarction (MI), and healthy volunteers. We hypothesized that the characteristics of the injured myocardium in patients with MI and myocarditis may differ and that the PC will be higher in chronically injured myocardium (MI) compared with acutely injured myocardium (myocarditis).MethodsWe performed late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging and T1 mapping before and after administration of gadolinium (0.1 mmol/kg Gd-BOPTA) at 3 Tesla in 10 healthy volunteers (47.1 ± 12.4 years), 18 patients with chronic MI (62.5 ± 8.1 years), and 16 patients with acute myocarditis (42.5 ± 13.9 years).ResultsIn patients with chronic MI and focal scar by LGE, the whole left ventricular myocardial PC (0.45 ± 0.05) was higher compared with patients with MI without focal scar (0.39 ± 0.03, P = 0.02) but not significantly different from whole myocardial PC in volunteers (0.40 ± 0.05) or patients with myocarditis (0.41 ± 0.05). The PC in myocarditis scars was lower than in chronic MI scars (0.60 ± 0.12 vs 0.77 ± 0.16, P = 0.016). The relationships of PC and scar burden, expressed as % LGE, were similar and significant for the 2 groups (P = 0.042).ConclusionThe tissue-blood partition coefficient of Gd-BOPTA is elevated in areas of acute and chronic myocardial injury and may serve as a marker for disease activity and density of scars, which was found to be higher in chronic MI than in acute myocarditis. |
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Keywords: | Corresponding author: Dr François-Pierre Mongeon, Philippa & Marvin Carsley CMR Center, Montréal Heart Institute, 5000 Bélanger Street, Montréal, Québec H3T 1C1, Canada. Tel.: +1-514-376-3330 fax: +1-514-593-2158. |
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