Cardiac magnetic resonance T1 mapping of left atrial myocardium

Roy Beinart, Irfan M. Khurram, Songtao Liu, Hirad Yarmohammadi, Henry R. Halperin, David A. Bluemke, Neville Gai, Rob J. Van Der Geest, Joao A.C. Lima, Hugh Calkins, Stefan L. Zimmerman, Saman Nazarian

Research output: Contribution to journalArticlepeer-review

Abstract

Background Cardiac magnetic resonance (CMR) T1 mapping is an emerging tool for objective quantification of myocardial fibrosis. Objectives To (a) establish the feasibility of left atrial (LA) T1 measurements, (b) determine the range of LA T1 values in patients with atrial fibrillation (AF) vs healthy volunteers, and (c) validate T1 mapping vs LA intracardiac electrogram voltage amplitude measures. Methods CMR imaging at 1.5 T was performed in 51 consecutive patients before AF ablation and in 16 healthy volunteers. T1 measurements were obtained from the posterior LA myocardium by using the modified Look-Locker inversion-recovery sequence. Given the established association of reduced electrogram amplitude with fibrosis, intracardiac point-by-point bipolar LA voltage measures were recorded for the validation of T1 measurements. Results The median LA T1 relaxation time was shorter in patients with AF (387 [interquartile range 364-428] ms) compared to healthy volunteers (459 [interquartile range 418-532] ms; P <.001) and was shorter in patients with AF with prior ablation compared to patients without prior ablation (P =.035). In a generalized estimating equations model, adjusting for data clusters per participant, age, rhythm during CMR, prior ablation, AF type, hypertension, and diabetes, each 100-ms increase in T1 relaxation time was associated with 0.1 mV increase in intracardiac bipolar LA voltage (P =.025). Conclusions Measurement of the LA myocardium T1 relaxation time is feasible and strongly associated with invasive voltage measures. This methodology may improve the quantification of fibrotic changes in thin-walled myocardial tissues.

Original languageEnglish (US)
Pages (from-to)1325-1331
Number of pages7
JournalHeart Rhythm
Volume10
Issue number9
DOIs
StatePublished - Sep 2013

Keywords

  • Atrial fibrillation
  • Cardiac magnetic resonance
  • Late gadolinium enhancement
  • Left atrial fibrosis
  • T1 mapping

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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