Diffusion tensor cardiovascular magnetic resonance: a clinical perspective
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Imaging the heart is central to cardiac phenotyping but in clinical practice this has been restricted to macroscopic interrogation. Diffusion tensor cardiovascular magnetic resonance (DT-CMR) is a novel, non-invasive technique which is beginning to unlock details of this microstructure in humans in-vivo. DT-CMR demonstrates the helical cardiomyocyte arrangement that drives rotation and torsion. Sheetlets (functional units of cardiomyocytes, separated by shear layers) have been shown to reorientate between diastole and systole, revealing how microstructural function facilitates cardiac thickening. Measures of tissue diffusion can also be made; fractional anisotropy (a measure of myocyte organisation) and mean diffusivity (a measure of myocyte packing). Abnormal myocyte orientation and sheetlet function has been demonstrated in congenital heart disease, cardiomyopathy and after myocardial infarction. It is too early to predict the clinical importance of DT-CMR, but such unique in-vivo information will likely prove valuable in early diagnosis and risk prediction of cardiac dysfunction and arrhythmias.
Date Issued
2020-05
Date Acceptance
2019-07-11
Citation
JACC: Cardiovascular Imaging, 2020, 13 (5), pp.1235-1255
ISSN
1936-878X
Publisher
Elsevier
Start Page
1235
End Page
1255
Journal / Book Title
JACC: Cardiovascular Imaging
Volume
13
Issue
5
Sponsor
British Heart Foundation
British Heart Foundation
Identifier
https://www.sciencedirect.com/science/article/pii/S1936878X19307259?via%3Dihub
Grant Number
RG/19/1/34160
RG/19/1/34160
Subjects
cardiomyocytes
diffusion tensor CMR
helix angle
microstructure
sheetlets
Cardiovascular System & Hematology
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
Publication Status
Published
Date Publish Online
2019-10-11