Myocardial T1-mapping and extracellular volume in pulmonary arterial hypertension: A systematic review and meta-analysis

Alabed, Samer, Saunders, Laura, Garg, Pankaj, Shahin, Yousef, Alandejani, Faisal, Rolf, Andreas, Puntmann, Valentina O., Nagel, Eike, Wild, Jim M., Kiely, David G. and Swift, Andrew J. (2021) Myocardial T1-mapping and extracellular volume in pulmonary arterial hypertension: A systematic review and meta-analysis. Magnetic Resonance Imaging, 79. pp. 66-75. ISSN 0730-725X

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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.

Item Type: Article
Additional Information: Funding Information: This work was supported by the Wellcome Trust awards ( 215799/Z/19/Z and 205188/Z/16/Z ). Publisher Copyright: © 2021 The Author(s)
Uncontrolled Keywords: cmr,cardiac mri,extracellular volume,meta-analysis,myocardial t mapping,pulmonary hypertension,biophysics,biomedical engineering,radiology nuclear medicine and imaging ,/dk/atira/pure/subjectarea/asjc/1300/1304
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 13 Nov 2021 01:52
Last Modified: 11 May 2022 00:41
DOI: 10.1016/j.mri.2021.03.011

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