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T1 mapping and conditional survival in paediatric dilated cardiomyopathy with advanced heart failure

Part of: Advanced Imaging

Published online by Cambridge University Press:  08 April 2021

Shashi Raj Open the ORCID record for Shashi Raj [Opens in a new window] ,
Richa Kothari ,
N Arun Kumar ,
Alben Sigamani  and
Vimal Raj
Shashi Raj*
Affiliation:
Pediatric Heart Failure and Heart Transplantation, Department of Pediatric Cardiology, Narayana Institute of Cardiac Sciences, NH Health City, Bengaluru, India
Richa Kothari
Affiliation:
Department of Cardiac Imaging, Narayana Institute of Cardiac Sciences, NH Health City, Bengaluru, India
N Arun Kumar
Affiliation:
Department of Clinical Research, NH Health City, Bengaluru, India
Alben Sigamani
Affiliation:
Department of Pharmacology, NH Institute of Medical Sciences, Bengaluru, India
Vimal Raj
Affiliation:
Department of Cardiac Imaging, Narayana Institute of Cardiac Sciences, NH Health City, Bengaluru, India
*
Author for correspondence: Dr S. Raj, MD, Department of Pediatric Cardiology, Narayana Institute of Cardiac Sciences, 258/A, Hosur Road, Bommasandra, Bengaluru, India. E-mail: drshashiraj@gmail.com
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Abstract

Myocardial fibrosis is associated with adverse events in idiopathic dilated cardiomyopathy. Cardiac MRI with late gadolinium enhancement can detect myocardial fibrosis. We evaluated the conditional survival of children and adolescents based on native T1 mapping (combined proton signal from myocytes and interstitium prior to contrast administration by the measurement of myocardial and blood relaxation time) as a means to assess myocardial fibrosis. This retrospective case–cohort over a 3-year period included all consecutive patients (aged ≤ 21 years) with advanced heart failure from dilated cardiomyopathy (echocardiographic left ventricular ejection fraction ≤ 45% and NYHA class ≥ 2) who underwent cardiac MRI.

Conditional survival (follow-up ≥ 6 months after cardiac MRI) was assessed to include NYHA functional class and time to event (death or heart transplantation). A total of 57 patients (mean age 11.7 ± 6.1 years; 58% male) had a median NYHA Class III (31/57) and median left ventricular ejection fraction 25% (20–38%). Survival data were available in 82% patients (46/57) and the crude mortality rate was 24% (11/46) and one patient (2%) underwent heart transplantation. The median native T1 was elevated at 1351 ms (95% CI 1332, 1394) and it showed no difference between the groups who survived to those who died. Performing a multilevel regression analysis on prognosis failed to predict 6-month conditional survival.

Keywords

Advanced heart failurecardiac MRIconditional survivaldilated cardiomyopathyT1 mapping
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 12 , December 2021 , pp. 1938 - 1942
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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