Assessment of myocardial partition coefficient of gadolinium (λ) in dilated cardiomyopathy and its impact on segmental and global systolic function

J Magn Reson Imaging. 2014 Dec;40(6):1336-41. doi: 10.1002/jmri.24515. Epub 2013 Nov 25.

Abstract

Purpose: 1) To assess the myocardial partition coefficient (λ) of gadolinium quantified using T1 mapping in dilated cardiomyopathy (DCM); and 2) to assess the impact of increased λ on left ventricular (LV) circumferential strain and ejection fraction in DCM.

Materials and methods: Seventeen patients with DCM and 11 controls were prospectively included. All patients and controls underwent a 1.5 T MRI using: 1) cine to quantify LV volumes and function; 2) tagging to quantify circumferential strain in mid-LV; 3) T1 mapping before and 9 minutes after contrast injection to quantify R1, ΔR1, and λ; and 4) inversion recovery 3D Flash was used to assess late gadolinium enhancement (LGE) 10 minutes after Gd DOTA injection (0.2 mmol/kg). We used Student's t-test to compare means, Pearson's test for correlation assessment, and a mixed linear model to integrate the dependency between myocardial segments.

Results: No difference in median λ was measured between patients with (0.52 [interquartile range = 0.48-0.56]) and without enhancement on LGE (0.51 [0.47-0.54]; P = 0.07). Circumferential strain value measured in each segment was correlated with the λ measured in the corresponding segment (r = 0.55; P < 0.0001). Multivariate analysis revealed a significant link between the λ in each segment and circumferential strain (0.002 ± 0.001; P = 0.009) and also with ejection fraction (-0.001 ± 0.0008; P = 0.04).

Conclusion: In DCM, λ correlates independently with circumferential strain and ejection fraction, suggesting that there is a link between λ and systolic function.

Keywords: MRI; contrast media; dilated cardiomyopathy; fibrosis; myocardium.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Cardiomyopathy, Dilated / complications
  • Cardiomyopathy, Dilated / diagnosis*
  • Cardiomyopathy, Dilated / metabolism*
  • Compressive Strength
  • Computer Simulation
  • Contrast Media / pharmacokinetics
  • Elastic Modulus
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Male
  • Meglumine / pharmacokinetics*
  • Metabolic Clearance Rate
  • Middle Aged
  • Models, Cardiovascular*
  • Organometallic Compounds / pharmacokinetics*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Stress, Mechanical
  • Stroke Volume
  • Tensile Strength
  • Tissue Distribution
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / etiology*
  • Ventricular Dysfunction, Left / metabolism*

Substances

  • Contrast Media
  • Organometallic Compounds
  • Meglumine
  • gadoterate meglumine