Myocardial extracellular volume fraction quantified by cardiovascular magnetic resonance is increased in hypertension and associated with left ventricular remodeling

• DOI: 10.1007/s00330-017-4841-9
• Publication Date: 2017-04-24T10:32:55Z
• Authors: Shuli Wang; Hongjie Hu; Minjie Lu; Arlene Sirajuddin; Jinghui Li; Jing An; Xiuyu Chen; Gang Yin; Tian Lan; Linlin Dai; Yan Zhang; Xiaorong Yin; Lei Song; Aimin Dang; Peter Kellman; Andrew E. Arai; Shihua Zhao
• Keywords: Adult; Gadolinium DTPA; Male; Ventricular Remodeling; Heart Ventricles; Magnetic Resonance Imaging, Cine; Middle Aged; Ventricular Function, Left; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Hypertension; Humans; Female; Hypertrophy, Left Ventricular; Prospective Studies

To determine whether extracellular volume fraction (ECV) quantification by cardiac magnetic resonance (CMR) can demonstrate left ventricle (LV) abnormalities and relationship between ECV and LV remodeling in hypertension (HTN) patients METHODS: ECV quantification was prospectively performed in 134 consecutive HTN patients and 97 healthy subjects. Individual and regional ECV were compared to the regions on late gadolinium enhancement (LGE) images. Statistical analysis of the relationship between LV global functional parameters and ECV was carried out using Pearson's correlation, Student's t test and multiple regressions.In the HTN group, 70.1% (94/134) were LGE negative and 29.9% (40/134) LGE positive. The mean ECV after adjusting for age, sex, BMI, diabetes, smoking and dyslipidaemia in healthy controls and LGE-negative patients were 26.9 ± 2.67% and 28.5 ± 2.9% (p < 0.001), respectively. The differences in ECV reached statistical significance among the regions of LGE, LGE-Peri, LGE remote and the normal area between the control and LGE-positive subgroup (all p < 0.05). Global ECV significantly correlated with LVEF (r = -0.466, p < 0 .001) and LV hypertrophy (r = 0.667, p < 0.001).ECV can identify LV abnormalities at an early stage in HTN patients without LGE. These abnormalities may reflect an increase in diffuse myocardial fibrosis and are associated with LV remodeling.• Diffuse myocardial fibrosis may develop in hypertensive cardiomyopathy before conventional MRI detectable LGE. • ECV can identify myocardial fibrosis at an early stage in hypertensive patients. • Elevated ECV is associated with decreased LV global function and LV remodeling in hypertension.