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T1 Mapping by CMR Imaging: From Histological Validation to Clinical Implication.
Andreas A Kammerlander1, Beatrice A Marzluf1, Caroline Zotter-Tufaro1
1Division of Cardiology, Medical University of Vienna, Vienna, Austria.
JACC. Cardiovascular Imaging
|December 20, 2015
Summary
Cardiac magnetic resonance T1 mapping accurately quantifies extracellular volume (ECV) noninvasively. Higher CMR-ECV is linked to increased cardiovascular events, suggesting prognostic value among imaging parameters.
Area of Science:
- Cardiology
- Medical Imaging
- Biomarkers
Background:
- Extracellular volume (ECV) expansion is a hallmark of heart failure.
- Cardiac magnetic resonance (CMR) T1 mapping offers a noninvasive method to estimate ECV.
- The diagnostic and prognostic implications of CMR-derived ECV require further elucidation.
Purpose of the Study:
- To prospectively assess the diagnostic accuracy and prognostic impact of CMR T1 mapping for ECV quantification.
- To validate CMR-ECV measurements against left ventricular biopsy.
- To investigate the association of CMR-ECV with cardiovascular outcomes.
Main Methods:
- 473 patients underwent CMR with T1 mapping (MOLLI sequence) for ECV calculation (CMR-ECV).
- Left ventricular biopsies were performed in 36 patients for methodological validation (TissueFAXS-ECV).
- Multivariable Cox regression analyzed the association between CMR-ECV and adverse cardiovascular events.
Main Results:
- CMR-ECV demonstrated significant correlation with biopsy-derived TissueFAXS-ECV (r = 0.493, p = 0.002).
- Higher CMR-ECV tertiles were associated with significantly increased cardiovascular event rates (log-rank p = 0.013).
- CMR-ECV was an independent predictor of outcome among imaging variables (p = 0.004).
Conclusions:
- CMR T1 mapping provides accurate noninvasive ECV quantification.
- CMR-ECV is independently associated with event-free survival when considered among imaging parameters.
- Further long-term studies are needed to define the prognostic value of CMR-ECV beyond established clinical factors.
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