Diffuse interstitial fibrosis in well-controlled hypertension
KeywordsSystemic Hypertension Hypertensive Subject Normotensive Control Diffuse Fibrosis British Heart Foundation
Diffuse myocardial fibrosis (DMF) is an important factor in cardiac disease but until recently could only be accurately assessed with biopsy. We hypothesised that DMF measured by EQ-CMR is elevated in isolated systemic hypertension. As such DMF may be a key biomarker in assessing the cardiac effects of systemic hypertension.
ECV measurement was by EQ-CMR. The T1 mapping sequence was ShMOLLI. The contrast agent was Gadoterate meglumine (Dotarem) at 0.1mmol/Kg (bolus) plus infusion at 15 minutes at 0.0011 mmol/kg/min. CMR was at 1.5T (Siemens Avanto).
ECV was measured in 43 well-controlled hypertensive patients from a specialist tertiary centre (median age 56, range 21 to 78, 55% male) and 50 healthy volunteers (median age 47, range 28 to 69, 58% male).
ECV was calculated by ECV = (1-hematocrit) x (1/T1)myo ÷ (1/T1)blood.
ECV is significantly higher in subjects with well-controlled isolated, systemic hypertension than in normotensive, healthy volunteers. Elevated ECV was predominantly measured in patients with higher mean blood pressures and hence increased mass index. The overlap between the two cohorts can therefore reflect the success of effective blood pressure control, affecting not only LVH, but also diffuse fibrosis. There was no overall correlation between mass index and ECV, which may suggest that ECV and by inference DMF is an independent factor in systemic hypertension.
British Heart Foundation; National Institute for Health Research.
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