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Myocardial transit time mapping by CMR: A novel potential parameter of microcirculatory dysfunction in hypertrophic

Junlin Yang1, Yong Cheng1, Jinxiu Yang1

  • 1Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Hefei, Anhui 230022, China.

European Journal of Radiology Open
|January 22, 2026
PubMed

Insights

Myocardial transit time (MyoTT) measured by cardiovascular magnetic resonance (CMR) is elevated in hypertrophic cardiomyopathy (HCM) patients, especially those with atrial fibrillation (AF). This parameter may indicate coronary microvascular dysfunction (CMD) in HCM.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biophysics

Background:

  • Hypertrophic cardiomyopathy (HCM) is a genetic heart condition often associated with coronary microvascular dysfunction (CMD).
  • Atrial fibrillation (AF) is a common complication in HCM patients, potentially worsening prognosis.
  • Current methods for assessing CMD in HCM have limitations.

Purpose of the Study:

  • To investigate myocardial transit time (MyoTT) using cardiovascular magnetic resonance (CMR) as a potential biomarker for CMD in HCM.
  • To evaluate the association of MyoTT with HCM and AF status.
  • To compare the diagnostic performance of MyoTT with other CMR-derived parameters.

Main Methods:

  • A cohort of 50 HCM patients and 50 healthy controls underwent CMR scans.
  • Parameters assessed included cardiac function, native T1, extracellular volume (ECV), myocardial strain, and MyoTT.
  • Logistic regression and receiver operating characteristic (ROC) analyses were used to evaluate associations and discriminative performance.

Main Results:

  • HCM patients showed significantly altered cardiac function, increased native T1, ECV, and MyoTT compared to controls.
  • MyoTT, native T1, ECV, and LV-GLS were significantly associated with HCM status.
  • In HCM patients, higher native T1 and MyoTT values were observed in those with AF.
  • MyoTT demonstrated good discriminative performance for HCM (AUC=0.848) and for AF within HCM (AUC=0.740).

Conclusions:

  • MyoTT is elevated in HCM patients and is associated with the presence of AF.
  • MyoTT may serve as a valuable non-invasive imaging marker for CMD in HCM, particularly in the context of AF.
  • Further research is warranted to explore the clinical implications of MyoTT in HCM management.
Abstract

Keywords:
Atrial fibrillationCardiovascular magnetic resonanceCoronary microvascular dysfunctionExtracellular volume fractionHypertrophic cardiomyopathyMyocardial transit time

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