Myocardial extracellular volume fraction quantified by cardiovascular magnetic resonance is increased in hypertension and associated with left ventricular remodeling
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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
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.
KeywordsCMR Extracellular volume fraction Fibrosis Hypertension Remodeling
Abbreviations and acronyms
Cardiac magnetic resonance
Extracellular volume fraction
Late gadolinium enhancement
Left ventricular end-diastolic volume index
Left ventricular ejection fraction
Left ventricular end-systolic volume index
Left ventricular hypertrophy
Maximum diastolic blood pressure
Maximum systolic blood pressure
Phase sensitive inversion recovery
Region of interest
Compliance with ethical standards
The scientific guarantor of this publication is Minjie Lu and Shihua Zhao.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
This study was supported in parts by the Research Grant of National Natural Science Foundation of China (81571647, 81370036 and 81620108015), Capital Clinically Characteristic Applied Research Fund (Z151100004015141), Beijing Natural Science Foundation (7152124) and the Fundamental Research Funds for the Central Universities (3332013105). This work was also partially supported by the Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, USA.
Statistics and biometry
One of the authors has significant statistical expertise.
Institutional Review Board approval was obtained.
Written informed consent was obtained from all subjects (patients) in this study.
• cross-sectional study
• performed at one institution
- 7.Guerin AP, Adda H, London GM, Marchais SJ (2004) Cardiovascular disease in renal failure. Minerva Irol Nefrol Ital J Urol Nephrol 56:279–288Google Scholar
- 25.Moon JC, Messroghli DR, Kellman P et al (2013) Myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement. J Cardiovasc Magn Reson: Off J Soc Cardiovasc Magn Reson 15:92CrossRefGoogle Scholar