Efficacy of Native T₁ Mapping for Patients With Non-Ischemic Cardiomyopathy and Ventricular Functional Mitral...

We investigated the efficacy of left ventricular (LV) myocardial damage by native T₁mapping obtained with cardiac magnetic resonance (CMR) for patients undergoing transcatheter edge-to-edge repair (TEER).

We studied 40 symptomatic non-ischemic heart failure (HF) patients and ventricular functional mitral regurgitation (VFMR) undergoing TEER. LV myocardial damage was defined as the native T₁Z-score, which was converted from native T₁values obtained with CMR. The primary endpoint was defined as HF rehospitalization or cardiovascular death over 12 months after TEER. Multivariable Cox proportional hazards analysis showed that the native T₁Z-score was the only independent parameter associated with cardiovascular events (hazard ratio 3.40; 95% confidential interval 1.51-7.67), and that patients with native T₁Z-scores <2.41 experienced significantly fewer cardiovascular events than those with native T₁Z-scores ≥2.41 (P=0.001). Moreover, the combination of a native T₁Z-score <2.41 and more severe VFMR (effective regurgitant orifice area [EROA] ≥0.30 cm²) was associated with fewer cardiovascular events than a native T₁Z-score ≥2.41 and less severe VFMR (EROA <0.30 cm²; P=0.002).

Assessment of baseline LV myocardial damage based on native T₁Z-scores obtained with CMR without gadolinium-based contrast media is a valuable additional parameter for better management of HF patients and VFMR following TEER.