Cardiac magnetic resonance in patients with ARVC and family members: the potential role of native T1 mapping

Georgios Georgiopoulos; Mattia Zampieri; Silvia Molaro; Anna Chaloupka; Alberto Aimo; Barbara Barra; Leema Roberts; Laura Monje-Garcia; Colin Evans; Nabeel Sheikh; Rachel Bastiaenen; Michael Cooklin; Pier Giorgio Masci; Gerald Carr-White; Gherardo Finocchiaro; Amedeo Chiribiri

doi:10.1007/s10554-021-02166-7

Cardiac magnetic resonance in patients with ARVC and family members: the potential role of native T1 mapping

Georgios Georgiopoulos^*, Mattia Zampieri, Silvia Molaro, Anna Chaloupka, Alberto Aimo, Barbara Barra, Leema Roberts, Laura Monje-Garcia, Colin Evans, Nabeel Sheikh, Rachel Bastiaenen, Michael Cooklin, Pier Giorgio Masci, Gerald Carr-White, Gherardo Finocchiaro, Amedeo Chiribiri

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

Abstract

Left ventricular (LV) involvement in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is not evaluated in the revised Task Force Criteria, possibly leading to underdiagnosis. This study explored the diagnostic role of myocardial native T1 mapping in patients with ARVC and their first-degree relatives. Thirty ARVC patients (47% males, mean age 45 ± 27 years) and 59 first-degree relatives not meeting diagnostic criteria underwent CMR with native T1 mapping. C MR was abnormal in 26 (87%) patients with ARVC. The right ventricle was affected in isolation in 13 (43%) patients. Prior to T1 mapping assessment, 2 (7%) patients exhibited isolated LV involvement and 11 (36%) patients showed features of biventricular disease. Left ventricular involvement was manifest as detectable LV late gadolinium enhancement (LGE) in 12 out of 13 cases. According to pre-specified inter-ventricular septal (IVS) T1 mapping thresholds, 11 (37%) patients revealed raised native T1 values including 5 out of the 17 patients who would otherwise have been classified as exhibiting a normal LV by conventional imaging parameters. Native septal T1 values were elevated in 22 (37%) of the 59 first-degree relatives included. Biventricular involvement is commonly observed in ARVC; native myocardial T1 values are raised in more than one third of patients, including a significant proportion of cases that would have been otherwise classified as exhibiting a normal LV using conventional CMR techniques. The significance of abnormal T1 values in first-degree relatives at risk will need validation through longitudinal studies.

Original language	English
Pages (from-to)	2037-2047
Number of pages	11
Journal	INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
Volume	37
Issue number	6
Early online date	7 Feb 2021
DOIs	https://doi.org/10.1007/s10554-021-02166-7
Publication status	Published - Jun 2021

Keywords

ARVC
Diagnosis
Late gadolinium enhancement
T1 mapping

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10.1007/s10554-021-02166-7

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Georgiopoulos, G., Zampieri, M., Molaro, S., Chaloupka, A., Aimo, A., Barra, B., Roberts, L., Monje-Garcia, L., Evans, C., Sheikh, N., Bastiaenen, R., Cooklin, M., Masci, P. G., Carr-White, G., Finocchiaro, G., & Chiribiri, A. (2021). Cardiac magnetic resonance in patients with ARVC and family members: the potential role of native T1 mapping. INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, 37(6), 2037-2047. https://doi.org/10.1007/s10554-021-02166-7

@article{5ec6a72af32e44aaa94cb999d0441bf2,

title = "Cardiac magnetic resonance in patients with ARVC and family members: the potential role of native T1 mapping",

abstract = "Left ventricular (LV) involvement in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is not evaluated in the revised Task Force Criteria, possibly leading to underdiagnosis. This study explored the diagnostic role of myocardial native T1 mapping in patients with ARVC and their first-degree relatives. Thirty ARVC patients (47% males, mean age 45 ± 27 years) and 59 first-degree relatives not meeting diagnostic criteria underwent CMR with native T1 mapping. C MR was abnormal in 26 (87%) patients with ARVC. The right ventricle was affected in isolation in 13 (43%) patients. Prior to T1 mapping assessment, 2 (7%) patients exhibited isolated LV involvement and 11 (36%) patients showed features of biventricular disease. Left ventricular involvement was manifest as detectable LV late gadolinium enhancement (LGE) in 12 out of 13 cases. According to pre-specified inter-ventricular septal (IVS) T1 mapping thresholds, 11 (37%) patients revealed raised native T1 values including 5 out of the 17 patients who would otherwise have been classified as exhibiting a normal LV by conventional imaging parameters. Native septal T1 values were elevated in 22 (37%) of the 59 first-degree relatives included. Biventricular involvement is commonly observed in ARVC; native myocardial T1 values are raised in more than one third of patients, including a significant proportion of cases that would have been otherwise classified as exhibiting a normal LV using conventional CMR techniques. The significance of abnormal T1 values in first-degree relatives at risk will need validation through longitudinal studies.",

keywords = "ARVC, Diagnosis, Late gadolinium enhancement, T1 mapping",

author = "Georgios Georgiopoulos and Mattia Zampieri and Silvia Molaro and Anna Chaloupka and Alberto Aimo and Barbara Barra and Leema Roberts and Laura Monje-Garcia and Colin Evans and Nabeel Sheikh and Rachel Bastiaenen and Michael Cooklin and Masci, {Pier Giorgio} and Gerald Carr-White and Gherardo Finocchiaro and Amedeo Chiribiri",

note = "Funding Information: Dr. Georgiopoulos was supported by a Research Fellowship from the European Association of Cardiovascular Imaging and a Postdoctoral Grant from the Alexander S. Onassis Foundation. Publisher Copyright: {\textcopyright} 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = jun,

doi = "10.1007/s10554-021-02166-7",

language = "English",

volume = "37",

pages = "2037--2047",

journal = "INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING",

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Georgiopoulos, G, Zampieri, M, Molaro, S, Chaloupka, A, Aimo, A, Barra, B, Roberts, L, Monje-Garcia, L, Evans, C, Sheikh, N, Bastiaenen, R, Cooklin, M , Masci, PG , Carr-White, G, Finocchiaro, G & Chiribiri, A 2021, 'Cardiac magnetic resonance in patients with ARVC and family members: the potential role of native T1 mapping', INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, vol. 37, no. 6, pp. 2037-2047. https://doi.org/10.1007/s10554-021-02166-7

TY - JOUR

T1 - Cardiac magnetic resonance in patients with ARVC and family members

T2 - the potential role of native T1 mapping

AU - Georgiopoulos, Georgios

AU - Zampieri, Mattia

AU - Molaro, Silvia

AU - Chaloupka, Anna

AU - Aimo, Alberto

AU - Barra, Barbara

AU - Roberts, Leema

AU - Monje-Garcia, Laura

AU - Evans, Colin

AU - Sheikh, Nabeel

AU - Bastiaenen, Rachel

AU - Cooklin, Michael

AU - Masci, Pier Giorgio

AU - Carr-White, Gerald

AU - Finocchiaro, Gherardo

AU - Chiribiri, Amedeo

N1 - Funding Information: Dr. Georgiopoulos was supported by a Research Fellowship from the European Association of Cardiovascular Imaging and a Postdoctoral Grant from the Alexander S. Onassis Foundation. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/6

Y1 - 2021/6

N2 - Left ventricular (LV) involvement in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is not evaluated in the revised Task Force Criteria, possibly leading to underdiagnosis. This study explored the diagnostic role of myocardial native T1 mapping in patients with ARVC and their first-degree relatives. Thirty ARVC patients (47% males, mean age 45 ± 27 years) and 59 first-degree relatives not meeting diagnostic criteria underwent CMR with native T1 mapping. C MR was abnormal in 26 (87%) patients with ARVC. The right ventricle was affected in isolation in 13 (43%) patients. Prior to T1 mapping assessment, 2 (7%) patients exhibited isolated LV involvement and 11 (36%) patients showed features of biventricular disease. Left ventricular involvement was manifest as detectable LV late gadolinium enhancement (LGE) in 12 out of 13 cases. According to pre-specified inter-ventricular septal (IVS) T1 mapping thresholds, 11 (37%) patients revealed raised native T1 values including 5 out of the 17 patients who would otherwise have been classified as exhibiting a normal LV by conventional imaging parameters. Native septal T1 values were elevated in 22 (37%) of the 59 first-degree relatives included. Biventricular involvement is commonly observed in ARVC; native myocardial T1 values are raised in more than one third of patients, including a significant proportion of cases that would have been otherwise classified as exhibiting a normal LV using conventional CMR techniques. The significance of abnormal T1 values in first-degree relatives at risk will need validation through longitudinal studies.

AB - Left ventricular (LV) involvement in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is not evaluated in the revised Task Force Criteria, possibly leading to underdiagnosis. This study explored the diagnostic role of myocardial native T1 mapping in patients with ARVC and their first-degree relatives. Thirty ARVC patients (47% males, mean age 45 ± 27 years) and 59 first-degree relatives not meeting diagnostic criteria underwent CMR with native T1 mapping. C MR was abnormal in 26 (87%) patients with ARVC. The right ventricle was affected in isolation in 13 (43%) patients. Prior to T1 mapping assessment, 2 (7%) patients exhibited isolated LV involvement and 11 (36%) patients showed features of biventricular disease. Left ventricular involvement was manifest as detectable LV late gadolinium enhancement (LGE) in 12 out of 13 cases. According to pre-specified inter-ventricular septal (IVS) T1 mapping thresholds, 11 (37%) patients revealed raised native T1 values including 5 out of the 17 patients who would otherwise have been classified as exhibiting a normal LV by conventional imaging parameters. Native septal T1 values were elevated in 22 (37%) of the 59 first-degree relatives included. Biventricular involvement is commonly observed in ARVC; native myocardial T1 values are raised in more than one third of patients, including a significant proportion of cases that would have been otherwise classified as exhibiting a normal LV using conventional CMR techniques. The significance of abnormal T1 values in first-degree relatives at risk will need validation through longitudinal studies.

KW - ARVC

KW - Diagnosis

KW - Late gadolinium enhancement

KW - T1 mapping

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U2 - 10.1007/s10554-021-02166-7

DO - 10.1007/s10554-021-02166-7

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SN - 1569-5794

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JF - INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING

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ER -

Cardiac magnetic resonance in patients with ARVC and family members: the potential role of native T1 mapping

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