"Myocardial transit-time" (MyoTT) : a novel and easy-to-perform CMR parameter to assess microvascular disease

BACKGROUND: Myocardial microvascular disease may occur during the disease course of different cardiac as well as systemic disorders. With the present study, we introduce a novel and easy-to-perform cardiovascular magnetic resonance (CMR) parameter named "myocardial transit-time" (MyoTT).

METHODS: N = 20 patients with known hypertrophic cardiomyopathy (HCM) and N = 20 control patients without relevant cardiac disease underwent dedicated CMR studies on a 1.5-T MR scanner. The CMR protocol comprised cine and late-gadolinium-enhancement (LGE) imaging as well as first-pass perfusion acquisitions at rest for MyoTT measurement. MyoTT was defined as the blood circulation time from the orifice of the coronary arteries to the pooling in the coronary sinus (CS), and accordingly measured as the temporal difference between the appearances of CMR contrast agent in the aortic root and the CS reflecting the transit-time of gadolinium in the myocardial microvasculature.

RESULTS: Patients with HCM had a significantly prolonged MyoTT compared to controls (11.0 (9.1-14.5) s vs. 6.5 (4.8-8.4) s, p < 0.001). This significant difference did not change when the individual heart rate was taken into consideration (MyoTT indexed, p < 0.001). Significant correlations were found between MyoTT and maximal left ventricular (LV) wall thickness (r = 0.771, p < 0.001), MyoTT and presence of LGE (r = 0.760, p < 0.001) as well as MyoTT and LV global longitudinal strain (r = 0.672, p < 0.001). ROC analysis resulted in an area-under-curve (AUC) of 0.90 for MyoTT and showed an optimal sensitivity/specificity cut-off of 7.85 s to differentiate HCM from controls.

CONCLUSION: "Myocardial transit-time" is a novel and easy-to-perform CMR parameter that allows a quick assessment of the extent of myocardial microvascular disease. This novel CMR parameter may open new vistas in the assessment of microvascular disease-not only in HCM patients. Future studies will show the usefulness and clinical relevance of this novel CMR parameter.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:109

Enthalten in:

Clinical research in cardiology : official journal of the German Cardiac Society - 109(2020), 4 vom: 01. Apr., Seite 488-497

Sprache:

Englisch

Beteiligte Personen:

Chatzantonis, Grigorios [VerfasserIn]
Bietenbeck, Michael [VerfasserIn]
Florian, Anca [VerfasserIn]
Meier, Claudia [VerfasserIn]
Korthals, Dennis [VerfasserIn]
Reinecke, Holger [VerfasserIn]
Yilmaz, Ali [VerfasserIn]

Links:

Volltext

Themen:

1BJ477IO2L
CMD
CMR
Contrast Media
Gadobutrol
HCM
Journal Article
Microvascular disease
MyoTT
Myocardial perfusion
Organometallic Compounds

Anmerkungen:

Date Completed 23.12.2020

Date Revised 03.11.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s00392-019-01530-x

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM299339610