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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
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Native T1 Mapping and Clinical Risk Characterization in Non-Ischemic Dilated Cardiomyopathy: A Cardiac Magnetic

Manuela Montatore1, Marco Rella2, Eleonora Indolfi3

  • 1Department of Clinical and Experimental Medicine, School of Medicine, University of Foggia, 71122 Foggia, Italy.

Journal of Cardiovascular Development and Disease
|June 25, 2026
PubMed
Summary

Risk stratification in non-ischemic dilated cardiomyopathy (DCM) is improved by septal native T1 mapping. Higher T1 values correlate with adverse outcomes, though not independently predictive in this study.

Keywords:
cardiac magnetic resonancedilated cardiomyopathylate gadolinium enhancementmyocardial fibrosisnative T1 mappingprognosisrisk stratification

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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

Published on: June 11, 2019

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomarkers

Background:

  • Risk stratification in non-ischemic dilated cardiomyopathy (DCM) is challenging, as traditional markers like left ventricular ejection fraction (LVEF) and late gadolinium enhancement (LGE) do not fully characterize myocardial tissue.
  • Septal native T1 mapping offers quantitative assessment of diffuse myocardial abnormalities, potentially enhancing tissue characterization within cardiac magnetic resonance (CMR) imaging.

Purpose of the Study:

  • To investigate the role of septal native T1 mapping in risk stratification for patients with non-ischemic DCM.
  • To assess the association between septal native T1 values and adverse clinical outcomes in this patient cohort.

Main Methods:

  • Retrospective single-center study of 45 non-ischemic DCM patients undergoing CMR with cine imaging, LGE, and native T1 mapping.
  • Septal native T1 was the primary parameter, with patients followed for a composite endpoint of mortality, ventricular arrhythmias, ICD therapy, and heart failure hospitalization.
  • Exploratory Cox regression and ROC analyses were performed to evaluate predictive value.

Main Results:

  • During median 15-month follow-up, 31.1% of patients experienced the composite endpoint.
  • Patients with events had lower LVEF, higher LVEDVi, and trended towards higher septal native T1 values (1047.5 ± 25.0 ms vs. 1031.5 ± 24.3 ms; p=0.065).
  • A septal native T1 threshold of 1042 ms showed an exploratory AUC of 0.70 for predicting the composite endpoint, with lower event-free survival above this threshold.

Conclusions:

  • Higher septal native T1 values were associated with adverse clinical outcomes in non-ischemic DCM patients.
  • Native T1 mapping showed potential as a risk stratification tool, but was not independently associated with the composite endpoint in exploratory analyses.
  • Further research with larger cohorts is warranted to confirm the independent predictive value of septal native T1 in DCM risk stratification.