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Master Thesis

T1mapping myocardique sans contraste en IRM 3Tesla dans la sténose aortique

Abstract : Background : T1 mapping using cardiac magnetic resonance was recently proposed as a promising non-contrast imaging technique for the assessment of diffuse myocardial fibrosis in aortic stenosis. yocardial fibrosis (MF) has proven negative clinical impact. Early detection of diffuse MF may be clinically useful for the management of patients with aortic stenosis (AS). Methods. Based on 160 consecutive patients with moderate to severe AS and 47 control subjects, we sought to provide reference values for native T1 mapping for 3T magnetic field strength in moderate AS, severe AS and control subjects and assess its reproducibility, to identify factors associated with the presence of diffuse MF in severe AS, to assess regional distribution of diffuse MF and to compare the level of diffuse MF in the different types of severe AS.
Results: mean native T1 progressively increased across controls, moderate AS and severe AS. The reproducibility was excellent. T1 times correlated significantly with left ventricular remodeling and functional alterations. Native T1 appears to be elevated in the basal segments of the septum in moderate AS and to extend apical segments in severe AS. Mean T1 time was higher in classical Low flow low gradiant (LFLG) AS than in the other types of AS, Paradoxical low flow low gradient (PLFG) AS and Normal flow low gradient (NFLG) AS had higher level of diffuse MF than moderate AS, but similar to high gradient AS.
Conclusion: assessment of diffuse MF in AS using native T1 mapping by CMR 3T is feasible and reproducible in practice. T1 value increases with the severity of AS along with morphological and functional left ventricle (LV) alterations, particularly in the basal segments of the septum. Classical LFLG had the highest level of diffuse MF, and PLFLG AS and NFLG AS had a level of diffuse MF similar to HG AS.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03113646
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Submitted on : Monday, January 18, 2021 - 2:50:15 PM
Last modification on : Tuesday, July 13, 2021 - 3:24:00 AM

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  • HAL Id : dumas-03113646, version 1

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Clara Elbaum-Sindres. T1mapping myocardique sans contraste en IRM 3Tesla dans la sténose aortique. Médecine humaine et pathologie. 2020. ⟨dumas-03113646⟩

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