TY - JOUR
T1 - Myocardial T1-mapping and extracellular volume in pulmonary arterial hypertension: A systematic review and meta-analysis
AU - Alabed, Samer
AU - Saunders, Laura
AU - Garg, Pankaj
AU - Shahin, Yousef
AU - Alandejani, Faisal
AU - Rolf, Andreas
AU - Puntmann, Valentina O.
AU - Nagel, Eike
AU - Wild, Jim M.
AU - Kiely, David G.
AU - Swift, Andrew J.
N1 - Funding Information: This work was supported by the Wellcome Trust awards ( 215799/Z/19/Z and 205188/Z/16/Z ).
PY - 2021/6/1
Y1 - 2021/6/1
N2 - Introduction: Elevated myocardial T
1-mapping and extracellular volume (ECV) measured on cardiac MR (CMR) imaging is associated with myocardial abnormalities such as oedema or fibrosis. This meta-analysis aims to provide a summary of T
1-mapping and ECV values in pulmonary arterial hypertension (PAH) and compare their values with controls. Methods: We searched CENTRAL, MEDLINE, Embase, and Web of Science in August 2020. We included CMR studies reporting T
1-mapping or ECV values in adults with any type of PAH. We calculated the mean difference of T
1-values and ECV between PAH and controls. Results: We included 12 studies with 674 participants. T
1-values were significantly higher in PAH with the highest mean difference (MD) recorded at the RV insertion points (RVIP) (108 milliseconds (ms), 95% confidence intervals (CI) 89 to 128), followed by the RV free wall (MD 91 ms, 95% CI 56 to 126). The pooled mean T
1-value in PAH at the RVIP was 1084, 95% CI (1071 to 1097) measured using 1.5 Tesla Siemens systems. ECV was also higher in PAH with an MD of 7.5%, 95% CI (5.9 to 9.1) at the RV free wall. Conclusion: T
1 mapping values in PAH patients are on average 9% higher than healthy controls when assessed under the same conditions including the same MRI system, magnetic field strength or sequence used for acquisition. The highest T
1 and ECV values are at the RVIP. T
1 mapping and ECV values in PH are higher than the values reported in cardiomyopathies and were associated with poor RV function and RV dilatation.
AB - Introduction: Elevated myocardial T
1-mapping and extracellular volume (ECV) measured on cardiac MR (CMR) imaging is associated with myocardial abnormalities such as oedema or fibrosis. This meta-analysis aims to provide a summary of T
1-mapping and ECV values in pulmonary arterial hypertension (PAH) and compare their values with controls. Methods: We searched CENTRAL, MEDLINE, Embase, and Web of Science in August 2020. We included CMR studies reporting T
1-mapping or ECV values in adults with any type of PAH. We calculated the mean difference of T
1-values and ECV between PAH and controls. Results: We included 12 studies with 674 participants. T
1-values were significantly higher in PAH with the highest mean difference (MD) recorded at the RV insertion points (RVIP) (108 milliseconds (ms), 95% confidence intervals (CI) 89 to 128), followed by the RV free wall (MD 91 ms, 95% CI 56 to 126). The pooled mean T
1-value in PAH at the RVIP was 1084, 95% CI (1071 to 1097) measured using 1.5 Tesla Siemens systems. ECV was also higher in PAH with an MD of 7.5%, 95% CI (5.9 to 9.1) at the RV free wall. Conclusion: T
1 mapping values in PAH patients are on average 9% higher than healthy controls when assessed under the same conditions including the same MRI system, magnetic field strength or sequence used for acquisition. The highest T
1 and ECV values are at the RVIP. T
1 mapping and ECV values in PH are higher than the values reported in cardiomyopathies and were associated with poor RV function and RV dilatation.
KW - CMR
KW - Cardiac MRI
KW - Extracellular volume
KW - Meta-analysis
KW - Myocardial T mapping
KW - Pulmonary hypertension
UR - http://www.scopus.com/inward/record.url?scp=85102900352&partnerID=8YFLogxK
U2 - 10.1016/j.mri.2021.03.011
DO - 10.1016/j.mri.2021.03.011
M3 - Article
VL - 79
SP - 66
EP - 75
JO - Magnetic Resonance Imaging
JF - Magnetic Resonance Imaging
SN - 0730-725X
ER -