von Stumm Maria, Petersen Johannes, Sinn Martin, Holst Theresa, Sequeira-Gross Tatiana M, Müller Lisa, Pausch Jonas, Bannas Peter, Adam Gerhard, Reichenspurner Hermann, Girdauskas Evaldas
Department for Congenital and Pediatric Heart Surgery, German Heart Center Munich, 80636 Munich, Germany.
Department of Cardiovascular Surgery, University Heart & Vascular Center, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
J Clin Med. 2023 Apr 2;12(7):2649. doi: 10.3390/jcm12072649.
Myocardial native T1 is a known cardiovascular magnetic resonance (CMR) imaging biomarker to quantify diffuse myocardial fibrosis in valvular cardiomyopathy. We hypothesized that diffuse myocardial fibrosis assessed by preoperative T1 mapping might correlate with LV reverse remodeling after valvular surgery. A prospective monocentric cohort study was conducted including 79 consecutive patients with valvular cardiomyopathy referred for surgical treatment of severe aortic or severe functional mitral regurgitation. Native T1 values were assessed by CMR before surgery. LV geometry parameters (i.e., LVEDV, LVESV) were obtained by 2D transthoracic echocardiography before and six months after surgery. Postoperative change of LV geometry parameters was calculated as delta (∆) variable (i.e., six months value minus baseline value). Mean native T1 was 1047 ± 39 ms, mean ∆LVEDV was -33 ± 42 mL, and mean ∆LVESV was -15 ± 27 mL. Native T1 values correlated with ∆LVEDV (Pearson r = 0.29; = 0.009) and ∆LVESV (Pearson r = 0.29; = 0.015). Native T1 values < 1073 ms were identified as independent predictor of postoperative reduction of LVEDV (HR 3.0; 95%-CI: 1.1-8.0; = 0.03) and LVESV (HR 2.9; 95%-CI: 1.1-7.4; = 0.03). Diffuse myocardial fibrosis assessed by myocardial native T1 correlates with LV reverse remodeling at six months after valvular surgery. T1 mapping may be a valuable tool to predict LV reverse remodeling in valvular heart disease.
心肌固有T1是一种已知的心血管磁共振（CMR）成像生物标志物，用于量化瓣膜性心肌病中的弥漫性心肌纤维化。我们假设术前T1 mapping评估的弥漫性心肌纤维化可能与瓣膜手术后左心室逆向重构相关。进行了一项前瞻性单中心队列研究，纳入了79例连续的瓣膜性心肌病患者，这些患者因严重主动脉瓣反流或严重功能性二尖瓣反流接受手术治疗。术前通过CMR评估固有T1值。术前及术后6个月通过二维经胸超声心动图获得左心室几何参数（即左心室舒张末期容积、左心室收缩末期容积）。左心室几何参数的术后变化计算为变量差值（∆）（即6个月时的值减去基线值）。平均固有T1为1047±39 ms，平均∆左心室舒张末期容积为-33±42 mL，平均∆左心室收缩末期容积为-15±27 mL。固有T1值与∆左心室舒张末期容积（Pearson r = 0.29；P = 0.009）和∆左心室收缩末期容积（Pearson r = 0.29；P = 0.015）相关。固有T1值<1073 ms被确定为左心室舒张末期容积术后减少（HR 3.0；95%可信区间：1.1-8.0；P = 0.03）和左心室收缩末期容积术后减少（HR 2.9；95%可信区间：1.1-7.4；P = 0.03）的独立预测因素。心肌固有T1评估的弥漫性心肌纤维化与瓣膜手术后6个月的左心室逆向重构相关。T1 mapping可能是预测瓣膜性心脏病左心室逆向重构的有价值工具。
