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Updated: Dec 3, 2025
Ultrasonic Assessment of Myocardial Microstructure
Published on: January 14, 2014
Myocardial T1 mapping and extracellular volume quantification as novel biomarkers in risk stratification of patients
V Bordonaro1, D Bivort2, T Dresselaers1
1Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium.
Insights
Cardiovascular magnetic resonance (CMR) using native T1 mapping and extracellular volume (ECV) can predict adverse cardiac events in systemic sclerosis (SSc) patients, aiding in risk stratification.
Area of Science:
- Cardiology
- Radiology
- Rheumatology
Background:
- Cardiac involvement is common in systemic sclerosis (SSc).
- Accurate risk stratification for cardiac events in SSc patients is crucial.
- Non-invasive markers for myocardial fibrosis are needed.
Purpose of the Study:
- To evaluate the prognostic value of myocardial native T1 and extracellular volume (ECV) using cardiovascular magnetic resonance (CMR) in SSc patients.
- To assess the association of CMR findings with adverse cardiac outcomes.
Main Methods:
- Multiparametric CMR including native T1 mapping, ECV calculation, T2 mapping, and late gadolinium enhancement (LGE) was performed in 33 SSc patients.
- Patients were followed for cardiac death, significant arrhythmia, or heart failure.
- Results were compared to 33 healthy controls.
Main Results:
- SSc patients exhibited significantly higher myocardial native T1, T2, and ECV compared to controls.
- LGE was present in 24% of SSc patients.
- Elevated native T1, ECV, and LGE were significantly associated with adverse cardiac events in multivariate analysis.
Conclusions:
- Native T1 mapping and ECV are novel non-invasive biomarkers for myocardial fibrosis in SSc.
- These CMR parameters can aid in the risk stratification of SSc patients.
- CMR mapping offers potential for disease monitoring and evaluating antifibrotic therapies in SSc.
Aim:
To study the prognostic value of myocardial native T1 and extracellular volume (ECV), measured by cardiovascular magnetic resonance (CMR), in patients with systemic sclerosis (SSc).
Materials And Methods:
Thirty-three SSc patients (16/33 male, 48.5%) were studied using multiparametric CMR including native T1 mapping with ECV calculation, T2 mapping, and late gadolinium enhancement (LGE). Patients were followed-up for cardiac death, haemodynamically significant arrhythmia, or heart failure. Results were compared with 33 age- and gender-matched healthy controls.
Results:
When compared with controls, SSc patients had higher myocardial native T1 (1,058.9±71 versus 989.4±21.4 ms, p<0.001), higher T2 (54.9±5.7 versus 50±2.5 ms, p<0.001), and ECV values (27.9±5.4% versus 24.8±2%, p<0.004). LGE was present in eight patients (24%), two subendocardial, five midwall, and four subepicardial. LGE, native T1, and ECV were significantly associated with adverse events during follow-up in multivariate Cox regression analysis. Kaplan-Meier analysis demonstrated significant divergence of the survival curves based on the presence of elevated native T1 (≥1,069 ms) or ECV (≥31.4%) values.
Conclusion:
Cardiac involvement is frequent in SSc. Both native T1 mapping and ECV represent novel non-invasive markers of myocardial fibrosis and could be used in the risk stratification of patients with SSc. CMR mapping may provide a novel biomarker for disease monitoring and study of therapies aiming to reduce myocardial fibrosis in SSc.
