Assessment of Myocardial Microstructural Dynamics by In Vivo Diffusion Tensor Cardiac Magnetic Resonance

作者：Sònia Nielles‐Vallespin, Zohya Khalique, Pedro Ferreira, Ranil de Silva, Andrew D. Scott, Philip J. Kilner, Laura‐Ann McGill, Archontis Giannakidis, Peter Gatehouse, Daniel B. Ennis, Eric Aliotta, Majid Al-Khalil, Peter Kellman, Dumitru Mazilu, Robert S. Balaban, David Firmin, Andrew E. Arai, Dudley J. Pennell · 发表于：Journal of the American College of Cardiology · 年份：2017 · DOI：10.1016/j.jacc.2016.11.051 · 被引用次数：257 · 研究领域：Cardiovascular Function and Risk Factors、Cardiomyopathy and Myosin Studies、Advanced Neuroimaging Techniques and Applications

BACKGROUND: Cardiomyocytes are organized in microstructures termed sheetlets that reorientate during left ventricular thickening. Diffusion tensor cardiac magnetic resonance (DT-CMR) may enable noninvasive interrogation of in vivo cardiac microstructural dynamics. Dilated cardiomyopathy (DCM) is a condition of abnormal myocardium with unknown sheetlet function. OBJECTIVES: This study sought to validate in vivo DT-CMR measures of cardiac microstructure against histology, characterize microstructural dynamics during left ventricular wall thickening, and apply the technique in hypertrophic cardiomyopathy (HCM) and DCM. METHODS: In vivo DT-CMR was acquired throughout the cardiac cycle in healthy swine, followed by in situ and ex vivo DT-CMR, then validated against histology. In vivo DT-CMR was performed in 19 control subjects, 19 DCM, and 13 HCM patients. RESULTS: = 0.89), were consistently observed under all experimental conditions, and accorded closely with histological analyses in both relaxed and contracted states. The potential contribution of cyclical strain effects to in vivo E2A was ∼17%. In healthy human control subjects, E2A increased from diastole (18°) to systole (65°; p < 0.001; E2A mobility = 45°). HCM patients showed significantly greater E2A in diastole than control subjects did (48°; p < 0.001) with impaired E2A mobility (23°; p < 0.001). In DCM, E2A was similar to control subjects in diastole, but systolic values were markedly lower (40°; p < 0.001) with impaire...