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Increased myocardial native T1 relaxation time in patients with nonischemic dilated cardiomyopathy with complex

Shiro Nakamori1, An H Bui1,2, Jihye Jang1

  • 1Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

Journal of Magnetic Resonance Imaging : JMRI
|July 25, 2017
PubMed

Insights

Nonischemic dilated cardiomyopathy patients with complex ventricular arrhythmias show higher native T1 times, indicating more diffuse myocardial fibrosis. This finding is independently associated with arrhythmias, even after accounting for left ventricular function and scar.

Area of Science:

  • Cardiology
  • Radiology
  • Biomedical Imaging

Background:

  • Nonischemic dilated cardiomyopathy (NICM) is a significant cause of heart failure.
  • Complex ventricular arrhythmias (ComVA) are a serious complication in NICM patients.
  • Diffuse myocardial fibrosis is increasingly recognized as a substrate for arrhythmias.

Purpose of the Study:

  • To investigate the relationship between diffuse myocardial fibrosis and ComVA in NICM patients.
  • To test the hypothesis that NICM patients with ComVA have higher native T1 times, reflecting greater diffuse fibrosis.

Main Methods:

  • Prospective enrollment of NICM patients with (n=50) and without (n=57) ComVA.
  • 1.5T cardiac magnetic resonance imaging (MRI) including cine, late gadolinium enhancement (LGE), and native T1 mapping.
  • Assessment of left ventricular (LV) function, focal scar, and diffuse fibrosis using T1 values.

Main Results:

  • Global native T1 time was significantly higher in NICM patients with ComVA (1131 ± 42 msec) versus those without (1107 ± 45 msec).
  • This difference persisted after excluding segments with LGE (1124 ± 36 vs. 1102 ± 44 msec).
  • Native T1 was an independent predictor of ComVA (OR 1.14 per 10-msec increment), beyond LV function and LGE.

Conclusions:

  • NICM patients with ComVA exhibit elevated native T1 values, suggesting more diffuse myocardial fibrosis.
  • Native myocardial T1 is independently associated with the presence of ComVA in NICM.
  • T1 mapping provides valuable insights into arrhythmia substrate in NICM.
Abstract

Keywords:
diffuse myocardial fibrosis. ventricular arrhythmianative T1 mappingnonischemic dilated cardiomyopathy

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