Background
Methods
Study subjects
CMR acquisition
Image analysis
Statistical analysis
Results
Patients’ characteristics
DCM MR (+), N = 22 | DCM MR (-), N = 18 | Controls, N = 20 |
* P-value DCM MR (+) vs DCM MR (-) |
* P-value DCM MR (+) vs Controls |
* P-value DCM MR (-) vs Controls | |
---|---|---|---|---|---|---|
Demographics | ||||||
Male, % | 15 (68 %) | 16 (89 %) | 13 (65 %) | 0.12 | 0.83 | 0.083 |
Age, years | 52 ± 16 | 58 ± 13 | 54 ± 13 | 0.32 | 0.98 | 0.44 |
Height, cm | 176 ± 9 | 175 ± 8 | 172 ± 8 | 0.99 | 0.41 | 0.52 |
Body weight, kg | 93 ± 20 | 86 ± 15 | 79 ± 15 | 0.47 | 0.10 | 0.67 |
BMI, kg | 30 ± 7 | 28 ± 6 | 27 ± 4 | 0.51 | 0.21 | 0.86 |
BSA, m2
| 2.1 ± 0.3 | 2.0 ± 0.2 | 1.9 ± 0.2 | 0.58 | 0.10 | 0.57 |
SBP, mmHg | 116 ± 14 | 119 ± 17 | 119 ± 12 | 0.80 | 0.70 | 0.99 |
DBP, mmHg | 70 ± 11 | 74 ± 14 | 71 ± 10 | 0.53 | 0.70 | 0.59 |
Heart rate, bpm | 76 ± 12 | 73 ± 12 | 68 ± 14 | 0.77 | 0.14 | 0.47 |
Medications | ||||||
Aspirin | 7 (32 %) | 7 (39 %) | - | 0.64 | - | - |
ACE/ARBs | 18 (82 %) | 16 (89 %) | - | 0.38 | - | - |
Calcium channel blockers | 2 (9 %) | 2 (11 %) | - | 0.83 | - | - |
Beta blockers | 17 (77 %) | 14 (78 %) | - | 0.97 | - | - |
Diuretics | 11 (50 %) | 7 (39 %) | - | 0.48 | - | - |
Aldosterone inhibitors | 2 (9 %) | 1 (6 %) | - | 0.67 | - | - |
Statin | 9 (41 %) | 9 (50 %) | - | 0.57 | - | - |
Warfarin | 5 (8 %) | 2 (11 %) | - | 0.90 | - | - |
Cine MRI and LGE findings
DCM MR (+), N = 22 | DCM MR (-), N = 18 | Controls, N = 20 |
* P-value DCM MR (+) vs DCM MR (-) |
* P-value DCM MR (+) vs Controls |
* P-value DCM MR (-) vs Controls | |
---|---|---|---|---|---|---|
Cine MRI parameters | ||||||
EDVI, mL/m2
| 129 ± 43 | 122 ± 36 | 80 ± 16 | 0.79 | <0.05 | <0.05 |
ESVI. mL/m2
| 89 ± 43 | 84 ± 36 | 32 ± 10 | 0.86 | <0.05 | <0.05 |
SVI, mL/m2
| 40 ± 11 | 38 ± 10 | 48 ± 10 | 0.86 | 0.04 | 0.02 |
LVEF, % | 34 ± 13 | 33 ± 11 | 61 ± 4 | 0.98 | <0.05 | <0.05 |
LVMI, g/m2
| 67 ± 23 | 68 ± 17 | 46 ± 9 | 0.99 | <0.05 | <0.05 |
RVEF, % | 52 ± 10 | 52 ± 14 | 58 ± 5 | 1.00 | 0.15 | 0.18 |
LA dimension, mm | 58 ± 9 | 55 ± 7 | 52 ± 9 | 0.59 | 0.06 | 0.41 |
LA area (2 chamber view), cm2
| 29 ± 9 | 25 ± 6 | - | 0.21 | - | - |
LA area (4 chamber view), cm2
| 28 ± 9 | 23 ± 6 | - | 0.07 | - | - |
LA volume (ml) | 125 ± 54 | 92 ± 31 | - | 0.04 | ||
RA dimension, mm | 51 ± 10 | 52 ± 9 | 55 ± 9 | 0.98 | 0.42 | 0.58 |
LGE findings | ||||||
LV LGE | 3 (15 %) | 5 (27 %) | 0 (0 %) | 0.27 | 0.09 | 0.01 |
Papillary muscle LGE | 0 (0 %) | 0 (0 %) | 0 (0 %) | - | - | - |
DCM MR (+), N = 22 | DCM MR (-), N = 18 | Controls, N = 20 |
* P-value DCM MR (+) vs DCM MR (-) |
* P-value DCM MR (+) vs Controls |
* P-value DCM MR (-) vs Controls | |
---|---|---|---|---|---|---|
Maximum anterior PAP diameter, mm | 11.6 ± 3.3 | 10.2 ± 1.5 | 7.9 ± 1.3 | 0.14 | <0.05 | <0.05 |
Minimum anterior PAP diameter, mm | 7.9 ± 1.9 | 7.6 ± 1.4 | 6.8 ± 0.5 | 0.73 | <0.05 | 0.19 |
Maximum posterior PAP diameter, mm | 10.6 ± 3.1 | 9.3 ± 1.5 | 7.0 ± 0.6 | 0.14 | <0.05 | <0.05 |
Minimum posterior PAP diameter, mm | 6.9 ± 1.7 | 7.1 ± 0.9 | 5.0 ± 0.5 | 0.79 | <0.05 | <0.05 |
Maximum anterior PAP length, mm | 44.7 ± 7.6 | 42.3 ± 6.3 | 34.5 ± 2.8 | 0.42 | <0.05 | <0.05 |
Minimum anterior PAP length, mm | 37.6 ± 6.8 | 31.6 ± 5.4 | 23.5 ± 2.9 | <0.05 | <0.05 | <0.05 |
Maximum posterior PAP length, mm | 40.9 ± 8.4 | 37.8 ± 5.8 | 32.9 ± 3.1 | 0.28 | <0.05 | <0.05 |
Minimum posterior PAP length, mm | 33.7 ± 7.3 | 27.9 ± 3.5 | 22.6 ± 3.1 | <0.05 | <0.05 | <0.05 |
Anterior PAP shortening, % | 15.8 ± 4.4 | 25.5 ± 4.1 | 32.0 ± 4.8 | <0.05 | <0.05 | <0.05 |
Posterior PAP shortening, % | 17.7 ± 5.8 | 26.0 ± 3.4 | 31.5 ± 4.9 | <0.05 | <0.05 | <0.05 |
Mitral annulus (4chamber), mm | 37.8 ± 6.6 | 32.5 ± 3.8 | 28.7 ± 1.1 | <0.05 | <0.05 | <0.05 |
Mitral annulus (2chamber), mm | 38.5 ± 4.5 | 34.2 ± 5.1 | 31.6 ± 2.0 | <0.05 | <0.05 | <0.05 |
Tenting height, mm | 10.3 ± 1.1 | 6.1 ± 1.7 | 2.7 ± 1.3 | <0.05 | <0.05 | <0.05 |
Anterior mitral leaflet length, mm | 23.6 ± 3.5 | 19.9 ± 2.3 | 21.7 ± 1.6 | <0.05 | 0.06 | 0.11 |
Posterior mitral leaflet length, mm | 13.9 ± 4.0 | 12.6 ± 1.9 | 10.4 ± 1.4 | 0.27 | <0.05 | <0.05 |
Intra observer variability | Inter observer variability | |||
---|---|---|---|---|
ICC | 95 % CI | ICC | 95 % CI | |
Maximum papillary muscle diameter | 0.93 | 0.84–0.97 | 0.92 | 0.81–0.97 |
Minimum papillary muscle diameter | 0.87 | 0.69–0.94 | 0.82 | 0.61–0.93 |
Maximum papillary muscle length | 0.91 | 0.78–0.96 | 0.88 | 0.73–0.95 |
Minimum papillary muscle length | 0.91 | 0.78–0.96 | 0.86 | 0.70–0.95 |
Comparison of papillary muscle T1 time between cardiomyopathy and healthy control subjects
Relationship between papillary muscle T1 time and mitral regurgitant fraction
Univariable analysis | Multivariable analysis | |||||
---|---|---|---|---|---|---|
B | 95 % CI for β |
P-value | B | 95 % CI for β |
P-value | |
Age, year | −0.01 | −0.20–0.18 | 0.90 | - | - | - |
Gender, male | −3.99 | −10.50–2.53 | 0.22 | - | - | - |
Body mass index, kg/m2
| 0.22 | −0.21–0.71 | 0.28 | - | - | - |
LVEDVI, mL/m2
| 0.05 | −0.02–0.12 | 0.18 | - | - | - |
LVEF, % | −0.16 | −0.40–0.07 | 0.17 | - | - | - |
LVMI, g/m2
| 0.06 | −0.08–0.20 | 0.37 | - | - | - |
Left atrial area (4 chamber), cm2
| 0.56 | 0.23–0.91 | <0.05 | 0.17 | −1.05–1.39 | 0.25 |
Left atrial area (2 chamber), cm2
| 0.36 | −0.16–0.89 | 0.17 | - | - | - |
Left atrial volume, cm3
| 0.10 | 0.04–0.16 | <0.05 | −0.01 | −0.21–0.20 | 0.95 |
Mitral annulus (4 chamber), mm | 0.43 | −0.01–0.87 | 0.06 | - | - | - |
Tenting height, mm | 2.28 | 1.38–3.17 | <0.05 | 0.61 | −0.37–1.59 | 0.21 |
Anterior papillary muscle maximum diameter, mm | 1.28 | 0.34–2.23 | <0.05 | 0.29 | −0.59–1.16 | 0.51 |
Posterior papillary muscle maximum diameter, mm | 1.37 | 0.35–2.38 | <0.05 | 0.73 | −0.23–1.68 | 0.13 |
Anterior papillary muscle shortening, % | −0.87 | −1.20– −0.54 | <0.05 | −0.10 | −0.68–0.49 | 0.74 |
Posterior papillary muscle shortening, % | −0.92 | −1.24– −0.60 | <0.05 | −0.21 | −0.75–0.32 | 0.42 |
Papillary muscle T1 time, sec | 0.16 | 0.12–0.21 | <0.05 | 0.10 | 0.03–0.17 | <0.05 |
Univariable analysis | Multivariable analysis | |||||
---|---|---|---|---|---|---|
B | 95 % CI for β |
P-value | B | 95 % CI for β |
P-value | |
Age, year | 0.08 | −0.11–0.26 | 0.41 | - | - | - |
Gender, male | −0.49 | −6.85–5.86 | 0.87 | - | - | - |
Body mass index, kg/m2
| 0.17 | −0.29–0.64 | 0.44 | - | - | - |
LVEDVI, mL/m2
| 0.05 | −0.02–0.11 | 0.17 | - | - | - |
LVEF, % | −0.17 | −0.40–0.05 | 0.12 | - | - | - |
LVMI, g/m2
| 0.06 | −0.06–0.20 | 0.28 | - | - | - |
Left atrial area (4 chamber), cm2
| 0.34 | 0.01–0.68 | <0.05 | 0.13 | −0.24–0.30 | 0.85 |
Left atrial area (2 chamber), cm2
| 0.14 | −0.21–0.49 | 0.42 | - | - | - |
Left atrial volume, cm3
| 0.05 | −0.01–0.11 | 0.08 | |||
Mitral annulus (4 chamber), mm | −0.05 | −0.50–0.41 | 0.83 | - | - | - |
Tenting height, mm | 1.46 | −1.09–4.01 | 0.24 | - | - | - |
Anterior papillary muscle maximum diameter, mm | 0.64 | −0.22–1.51 | 0.14 | - | - | - |
Posterior papillary muscle maximum diameter, mm | 0.93 | 0.05–1.82 | <0.05 | 1.32 | 0.50–2.16 | <0.05 |
Anterior papillary muscle shortening, % | 0.31 | −1.12– −0.21 | 0.17 | - | - | - |
Posterior papillary muscle shortening, % | −0.51 | −0.97– −0.05 | <0.05 | −0.17 | −0.58–0.23 | 0.41 |
Papillary muscle T1 time, sec | 0.11 | 0.02–0.20 | <0.05 | 0.11 | 0.03–0.20 | <0.05 |