Myocardial perfusion, interstitial fibrosis and cardiomyocyte volume in the development of cardiac hypertrophy measured with contrast-enhanced MRI

Summary

Recent pre-clinical studies have indicated that in addition to measures of myocardial perfusion and interstitial fibrosis, contrast-enhanced MRI may be sensitive to changes in cardiomyocyte volume due to limitations in the rate of water exchange across the cell wall [1]. This is a potentially useful measure of early cardiac hypertrophy but the sensitivity and precision of such measurements has not yet been established.

Methods:

Simulation studies will be undertaken to determine the sensitivity of dynamic contrast-enhanced MRI to changes in cardiomyocyte volume. The effect of multiple contrast agent injections and changes in the way in which the MRI data are acquired will be assessed. Once an optimized imaging protocol is designed, MRI studies will be performed in volunteers and subsequently in patients before and after surgical aortic valve replacement. Estimates of myocardial perfusion, cardiomyocyte and interstitial volume will be obtained from those data.

Outcomes:

The project will produce recommendations for optimized MR imaging protocols to measure cardiomyocyte volume and assess the effect of aortic valve replacement on the parameters measured.

References:

• Coelho-Filho OR, Mongeon FP, Mitchell R, Moreno H, Jr., Nadruz W, Jr., Kwong R, et al. Role of transcytolemmal water-exchange in magnetic resonance measurements of diffuse myocardial fibrosis in hypertensive heart disease. Circulation: Cardiovasc Imaging. 2013;6(1):134-41.

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