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T1 and ECV Mapping in Myocardial Disease

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      Abstract

      T1 mapping using cardiovascular magnetic resonance (CMR) introduces novel techniques for myocardial tissue characterization to detect and quantify disease processes occurring at the microscopic level. Even though T1 mapping has limited spatial resolution, cellular and molecular changes occurring within each voxel can affect the aggregate T1 signal rendering them quantifiable. The estimated T1-based parameters quantified on a “map” demonstrate the spatial localization of these changes whereby each pixel expresses the quantitative value of that parameter. This quantification permits detection of diffuse disease even if it is not directly visible. Rather than relying on nonspecific functional measures, T1 mapping focuses on intrinsic changes of myocardial composition that advances understanding about specific disease pathways. These changes in myocardial tissue composition inform diagnosis and prognosis. T1 mapping encompasses two key parameters: native (i.e., precontrast) T1 and extracellular volume fraction (ECV) derived from additional postcontrast T1 and blood T1 measurements. These advances introduce new tools to detect focal and diffuse myocardial derangements occurring in cardiac disease that can be otherwise difficult to detect. T1 and ECV mapping foster precision medicine and personalized care, promising to improve patient outcomes through targeted therapy. Capitalizing on the opportunities introduced by T1 mapping and ECV requires further investigation.

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      Early myocardial and skeletal muscle interstitial remodelling in systemic sclerosis: insights from extracellular volume quantification using cardiovascular magnetic resonance.

      Systemic sclerosis (SSc) may induce cardiac fibrosis and systo-diastolic dysfunction. Cardiovascular magnetic resonance (CMR) can detect replacement myocardial fibrosis with late gadolinium enhancement (LGE) and interstitial myocardial fibrosis with T1 mapping techniques. The aim of the study was to detect subclinical cardiac involvement with CMR in paucisymptomatic SSc patients with no previous history of myocardial disease, comparing it with skeletal muscle remodelling.
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        Interstitial Fibrosis, Functional Status, and Outcomes in Heart Failure With Preserved Ejection Fraction: Insights From a Prospective Cardiac Magnetic Resonance Imaging Study.

        Myocardial extracellular volume (ECV) accumulation is one of the key pathophysiologic features of heart failure with preserved ejection fraction (HFpEF). Our aims were to (1) measure ECV by cardiac magnetic resonance T1 mapping using the modified Look-Locker inversion recovery (MOLLI) sequence, (2) validate MOLLI-ECV against histology, and (3) investigate the relationship between MOLLI-ECV and prognosis in HFpEF.
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          Native T1 and T2 mapping by CMR in lupus myocarditis: Disease recognition and response to treatment.

          Lupus myocarditis is likely more common than recognized clinically due to non-specific symptoms and lack of reliable non-invasive diagnostic tests. We investigated the role of native T1 and T2 in recognition of active myocardial inflammatory involvement in patients with systemic lupus erythematous (SLE).
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            Author and article information

            Affiliations
            1Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
            2Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
            3UPMC Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, Pittsburgh, PA, USA
            4Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
            Author notes
            Correspondence: Erik B. Schelbert, MD, MS, Director, Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, UPMC, Pittsburgh, PA, USA; and Assistant Professor of Medicine and Clinical and Translational Science, University of Pittsburgh School of Medicine, 200 Lothrop Street, PUH A349, Pittsburgh, PA 15101, USA, Tel.: 412-647-5840, Fax: 412-647-4227, E-mail: schelberteb@ 123456upmc.edu
            Journal
            CVIA
            Cardiovascular Innovations and Applications
            CVIA
            Compuscript (Ireland )
            2009-8782
            2009-8618
            March 2017
            March 2017
            : 2
            : 1
            : 73-84
            cvia20160066
            10.15212/CVIA.2016.0066
            Copyright © 2017 Cardiovascular Innovations and Applications

            This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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