Abstract 4369189: Cardiac MRI Measures of T1Rho, a Novel Imaging Marker of Diffuse Fibrosis, Are Elevated in Postpartum Women with Preeclampsia

Abstract

Background: Preeclampsia, a hypertensive pregnancy disorder, increases long-term cardiovascular disease (CVD) risk. While subclinical cardiac dysfunction postpartum has been reported, the role of myocardial fibrosis, scar tissue from injury, remains unclear. T1Rho (T1ρ), a new CMR mapping parameter, quantifies myocardial fibrosis without contrast and was validated in heart failure. However, its value in postpartum women with preeclampsia, who have chronic inflammation, is unknown. We tested the feasibility of measuring T1rho using 3T CMR and hypothesized that T1ρ (myocardial fibrosis), is elevated in postpartum women with preeclampsia compared to controls. Methods: We enrolled 21 women with and 23 without preeclampsia at a median of 4.5 months postpartum, matched for age, BMI, diabetes mellitus diagnosis, preexisting hypertension, and race/ethnicity who underwent research CMR (cardiovascular magnetic resonance). Mean cardiac T1ρ was measured in blinded manner (QMass/Medis software) and values compared between groups using t-tests for significance (p<0.05). Results: Women with and without preeclampsia were similar in age (mean 32.6 ± 5.7 years), diabetes mellitus diagnosis (20.5%), preexisting hypertension (27.3%), BMI (mean: 28.3 ± 10.8 kg/m^2), and race/ethnicity (50% White, 32% Black, and 7% Hispanic). T1ρ measures were significantly higher among women with (45.0 ± 2.3) vs. without preeclampsia (42.7 ± 2.9), p=0.007 (Figure 1). Conclusions: Women with preeclampsia have higher levels of diffuse myocardial fibrosis compared to controls. These findings provide novel evidence that increased myocardial fibrosis may contribute to increased long-term CVD risk in preeclamptic women.