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Hepatic T1-time, cardiac structure and function and cardiovascular outcomes in patients with dilated cardiomyopathy
Riccardo M Inciardi1, Marco Merlo2, Mariagiulia Bellicini1
1ASST Spedali Civili di Brescia, Division of Cardiology and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Insights
Higher liver T1-time in dilated cardiomyopathy (DCM) patients correlates with poorer cardiac function and increased risk of heart failure hospitalization or cardiovascular death. This finding highlights liver assessment
Area of Science:
- Cardiology
- Hepatology
- Medical Imaging
Background:
- Liver damage is common in cardiovascular disease (CVD) and linked to poor outcomes.
- The relationship between liver health, cardiac structure, and adverse events in dilated cardiomyopathy (DCM) is not well understood.
Purpose of the Study:
- To investigate the association between liver iron-corrected T1-time and cardiac parameters in DCM patients.
- To determine if liver T1-time predicts adverse cardiovascular events in this population.
Main Methods:
- Retrospective study of 120 DCM patients undergoing cardiac MRI.
- Assessed liver iron-corrected T1-time alongside standard cardiac function measures.
- Examined cross-sectional and longitudinal associations between liver T1-time and cardiac structure/function, and CV event risk.
Main Results:
- Higher liver T1-time was significantly associated with adverse left atrial structure, interventricular septum thickness, and right ventricular ejection fraction.
- Over 4.5 years, higher liver T1-time independently predicted increased risk of heart failure hospitalization or CV death (aHR 1.71).
- Patients with liver T1-time ≥563 ms faced a higher risk of CV events.
Conclusions:
- Elevated liver iron-corrected T1-time in DCM patients is linked to impaired cardiac size and function.
- Liver T1-time measured by cardiac MRI offers valuable prognostic information for CV risk stratification in DCM.
- Assessing liver tissue via MRI may enhance clinical management strategies for DCM patients.
Aim:
Liver damage frequently occurs in patients with cardiovascular (CV) disease and is associated with adverse clinical outcomes. The associations of liver damage with cardiac structure/function measures and the risk of adverse CV events in patients with dilated cardiomyopathy (DCM) are poorly known.
Methods:
We retrospectively enrolled consecutive patients with DCM undergoing cardiac magnetic resonance imaging (MRI). In addition to standard cardiac assessment, iron-corrected T1 mapping was also assessed in the liver. Cross-sectional associations between hepatic T1-time and cardiac structure and function were examined accounting for potential confounders. Longitudinal associations between hepatic T1-time and the risk of hospitalization for HF or CV death were also assessed.
Results:
Overall, 120 stable patients with established DCM were included in the study (mean age 54.7 years, 26 % women). The mean hepatic iron-corrected T1-time was 563±73 ms. In linear regression analyses, measures of left atrial structure (LA maximal volume, p = 0.035, LA minimal volume=0.012), interventricular septum thickness (p = 0.026), and right ventricular ejection fraction (p = 0.005) were significantly associated with greater hepatic T1-time. Over a mean follow-up of 4.5 ± 1.8 years, 32 (27 %) died or were hospitalized for HF at a rate of 6.7 per 100 person-year. Higher hepatic iron-corrected T1-time was independently associated with a higher risk of adverse events (adjusted-hazard ratio 1.71, 95 % confidence interval: 1.14-2.56, p = 0.009). Patients with a hepatic T1-time ≥563 ms had a higher risk of CV events (log-rank p = 0.03).
Conclusion:
Among stable patients with DCM, higher hepatic iron-corrected T1-time is associated with worse cardiac size and function and with higher rates of hospitalization for HF or CV death.
Condensed Abstract:
Limited data exist regarding the clinical value of hepatic T1-time in patients with dilated cardiomyopathy (DCM) undergoing cardiac Magnetic Resonance imaging (MRI). We found that higher hepatic iron-corrected T1-time is associated with worse cardiac size and function, even after accounting for clinical confounders. Over a mean follow-up of 4.5 ± 1.8 years, higher hepatic iron-corrected T1-time was independently associated with a higher risk of hospitalization for heart failure or cardiovascular death. Among stable patients with DCM, the evaluation of liver tissue by cardiac MRI may provide useful clinical information for CV risk stratification.
