Suzuki Atsushi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Association between myocardial hypoxia and fibrosis in hypertrophic cardiomyopathy: analysis by T2* BOLD and T1 mapping MRI.
Journal Formal name:European radiology
Abbreviation:Eur Radiol
ISSN code:09387994/14321084
Domestic / ForeginForegin
Publisher Springer
Volume, Issue, Page 30(8),4327-4336頁
Author and coauthor ANDO Kiyoe†, NAGAO Michinobu*, WATANABE Eri, SAKAI Akiko, SUZUKI Atsushi, NAKAO Risako, ISHIZAKI Umiko, SAKAI Shuji, HAGIWARA Nobuhisa
Publication date 2020/03
Summary OBJECTIVES:
We assessed whether an association exists between myocardial oxygenation and myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM), using blood-oxygen-level-dependent (BOLD) T2* cardiac magnetic resonance imaging (T2*-CMR) and T1 mapping.

METHODS:
T1 mapping and T2*-CMR data were collected from 55 HCM patients using a 3-T MR and were prospectively analyzed. T2*-CMR was conducted using the black blood, breath-hold, multi-echo, and gradient echo sequence. Over 10 min, inhalation of oxygen at the flow rate of 10 L/min, T2* for mid-septum was measured following room-air and oxygen inhalation, and ΔT2* ratio (T2*oxy-T2*air/T2*air, %) was calculated. During pre- and post-gadolinium enhancement, native T1 (ms) and extracellular volume fractions (ECV, %) were calculated at sites same as the T2* measurement. Hypoxia was defined as the segment with an absolute value of the ΔT2* ratio ≥ 10%.

RESULTS:
ΔT2* ratio was significantly higher for segments with native T1 ≥ 1290 ms than those with native T1 < 1290 ms (21 ± 32% vs. 8 ± 6%, p = 0.005). ΔT2* ratio was also significantly higher for segments with ECV ≥ 28% than those with ECV < 28% (21 ± 32% vs. 8 ± 8%, p = 0.0003). ROC curve analysis revealed that ΔT2* ratio could detect segments with native T1 ≥ 1290 ms and ECV ≥ 28% and c-statistics of 0.72 and 0.79. According to the multivariate logistic regression analysis results, ECV is an independent factor in hypoxia (odds ratio, 1.47; 95% confidence interval, 1.02-2.13; p < 0.05).

CONCLUSIONS:
Analysis of BOLD T2*-CMR and T1 mapping revealed that ECV is strongly associated with ΔT2* ratio, suggesting that the onset of myocardial fibrosis is related to hypoxia in HCM patients.
DOI 10.1007/s00330-020-06779-9
PMID 32211964