Value of T1 mapping technology in cardiac magnetic resonance for assessing the degree of myocardial fibrosis and prognosis in patients with aortic stenosis
Objective To explore the value of longitudinal relaxation time quantification(T1 mapping)technology in cardiac magnetic resonance(CMR)for assessing the degree of myocardial fibrosis and prognosis in patients with aortic stenosis(AS).Methods Fifty-one AS patients who underwent CMR imaging at Luzhou Traditional Chinese Medicine Hospital from March 2021 to August 2022 were included in the observation group.Additionally,49 healthy individuals without common cardiovascular symptoms such as chest tightness,palpitations,and angina,and with normal electrocardiogram findings,who underwent CMR imaging at the same period in our hospital,were selected as the control group.The left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),stroke volume(SV),left ventricular ejec-tion fraction(LVEF),left ventricular end-systolic volume index(LVESVI),left ventricular end-diastolic volume index(LVEDVI),myocardial mass,pre-contrast T1,post-contrast T1,and extracellular volume(ECV)were compared between the observation and control groups.The pre-contrast T1,post-contrast T1,and ECV of AS patients with different degrees of stenosis in the observation group were also compared.Pearson correlation analysis was used to assess the relationship be-tween pre-contrast T1,post-contrast T1,and ECV with LVEF.Univariate and multivariate logistic regression analyses were performed to identify factors affecting the prognosis of AS.The diagnostic efficacy of pre-contrast T1,post-contrast T1,and ECV alone or in combination for AS was compared.Results The LVEF and SV in the observation group were sig-nificantly higher than those in the control group,and the myocardial mass was significantly greater than that in the control group(P＜0.05).The pre-contrast T1 and ECV in the observation group were significantly higher than those in the control group,while the post-contrast T1 was significantly lower than that in the control group(P＜0.05).Comparison of pre-contrast T1,post-contrast T1,and ECV among AS patients with different degrees of stenosis:severe stenosis group＞mod-erate stenosis group＞mild stenosis group(P＜0.05).Pearson correlation analysis showed that pre-contrast T1 and ECV were negatively correlated with LVEF(r=-0.371,-0.428;P＜0.05),while post-contrast T1 was positively correlated with LVEF(r=0.495,P＜0.05).During follow-up,9 patients had poor prognosis,and 42 patients had good prognosis.Multivariate logistic regression analysis indicated that LVEF,SV,myocardial mass,ECV,pre-contrast T1,and post-con-trast T1 were independent factors affecting the prognosis of AS(P＜0.05).The ROC results indicated that the AUC,sensi-tivity,and specificity of the three parameters combined for diagnosing AS were 0.890,92.98％,and 89.18％,respectively,which were significantly higher than those of pre-contrast T1,post-contrast T1,and ECV alone.Conclusion T1 mapping technology in CMR can reflect the degree of myocardial fibrosis and prognosis in AS,holding promise for a wider application.
Aortic stenosisCMRFibrosisLongitudinal relaxation time quantificationPrognosis
万方数据
维普
