T1 Mapping in Cardiac Hypertrophy
Cardiac hypertrophy is defined as an increase in left ventricular mass and can result from a number of underlying pathologies including hypertensive heart disease, physiological hypertrophy in athletic heart, hypertrophic cardiomyopathy and infiltrative cardiac processes such as cardiac amyloidosis or storage diseases such as Fabry’s Disease. The end process of an increased LV mass can result from changes in both the intracellular space due to myocyte hypertrophy and/or due to expansion of the interstitial space by fibrosis, inflammation or protein deposition. While some changes in myocardial architecture manifest as focal scar, which can be detected by conventional late-gadolinium enhanced imaging (LGE), more diffuse processes cannot readily be detected, using conventional LGE techniques. It is in this situation where techniques based on T1 mapping, such as assessment of native T1 or extra-cellular volume (ECV), can provide unique insights into diffuse changes in the myocardial structure of a thickened heart muscle. This chapter will first review the relationship between T1 parameters of native T1 and ECV with the intracellular and extracellular spaces. Then we will review the current state of the art for using these T1 mapping techniques in cardiac pathologies characterized by left ventricular hypertrophy.
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