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Cardiovascular magnetic resonance native T2 and T2* quantitative values for cardiomyopathies and heart transplantations: a systematic review and meta-analysis

Authors
  • Snel, G. J. H.1
  • van den Boomen, M.1, 2
  • Hernandez, L. M.1
  • Nguyen, C. T.2, 2
  • Sosnovik, D. E.2, 2, 3
  • Velthuis, B. K.4
  • Slart, R. H. J. A.5, 6
  • Borra, R. J. H.1, 5
  • Prakken, N. H. J.1
  • 1 University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands , Groningen (Netherlands)
  • 2 Harvard Medical School, 149 13th Street, Charlestown, MA, 02129, USA , Charlestown (United States)
  • 3 Harvard-MIT, 7 Massachusetts Avenue, Cambridge, MA, 02139, USA , Cambridge (United States)
  • 4 University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands , Utrecht (Netherlands)
  • 5 University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands , Groningen (Netherlands)
  • 6 University of Twente, Dienstweg 1, Enschede, 7522 ND, The Netherlands , Enschede (Netherlands)
Type
Published Article
Journal
Journal of Cardiovascular Magnetic Resonance
Publisher
Springer (Biomed Central Ltd.)
Publication Date
May 11, 2020
Volume
22
Issue
1
Identifiers
DOI: 10.1186/s12968-020-00627-x
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe clinical application of cardiovascular magnetic resonance (CMR) T2 and T2* mapping is currently limited as ranges for healthy and cardiac diseases are poorly defined. In this meta-analysis we aimed to determine the weighted mean of T2 and T2* mapping values in patients with myocardial infarction (MI), heart transplantation, non-ischemic cardiomyopathies (NICM) and hypertension, and the standardized mean difference (SMD) of each population with healthy controls. Additionally, the variation of mapping outcomes between studies was investigated.MethodsThe PRISMA guidelines were followed after literature searches on PubMed and Embase. Studies reporting CMR T2 or T2* values measured in patients were included. The SMD was calculated using a random effects model and a meta-regression analysis was performed for populations with sufficient published data.ResultsOne hundred fifty-four studies, including 13,804 patient and 4392 control measurements, were included. T2 values were higher in patients with MI, heart transplantation, sarcoidosis, systemic lupus erythematosus, amyloidosis, hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM) and myocarditis (SMD of 2.17, 1.05, 0.87, 1.39, 1.62, 1.95, 1.90 and 1.33, respectively, P < 0.01) compared with controls. T2 values in iron overload patients (SMD = − 0.54, P = 0.30) and Anderson-Fabry disease patients (SMD = 0.52, P = 0.17) did both not differ from controls. T2* values were lower in patients with MI and iron overload (SMD of − 1.99 and − 2.39, respectively, P < 0.01) compared with controls. T2* values in HCM patients (SMD = − 0.61, P = 0.22), DCM patients (SMD = − 0.54, P = 0.06) and hypertension patients (SMD = − 1.46, P = 0.10) did not differ from controls. Multiple CMR acquisition and patient demographic factors were assessed as significant covariates, thereby influencing the mapping outcomes and causing variation between studies.ConclusionsThe clinical utility of T2 and T2* mapping to distinguish affected myocardium in patients with cardiomyopathies or heart transplantation from healthy myocardium seemed to be confirmed based on this meta-analysis. Nevertheless, variation of mapping values between studies complicates comparison with external values and therefore require local healthy reference values to clinically interpret quantitative values. Furthermore, disease differentiation seems limited, since changes in T2 and T2* values of most cardiomyopathies are similar.

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