Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences.
Department of Diagnostic Radiology, Hiroshima University Graduate School of Biomedical and Health Sciences.
Int Heart J. 2022;63(3):531-540. doi: 10.1536/ihj.21-801.
The evidence for the clinical implications, especially the short-term utility, of native myocardial T1 value (T1) on cardiac magnetic resonance (CMR) in nonischemic dilated cardiomyopathy (NIDCM) is scant. We investigated the potential of T1 to assess left ventricular (LV) myocardial characteristics and predict 1-year outcomes in patient with NIDCM experiencing recent heart failure (HF).Forty-five patients with NIDCM and HF symptoms within 3 months underwent CMR with cine, non-contrast T1 mapping, and late gadolinium enhancement (LGE). T1 per patient was defined as an averaged T1 value of 5 short-axis slices of base-to-apex LV myocardium. The appearance of LGE was visually examined. T1 correlated with the LV end-diastolic dimension normalized to height (LVEDD) (r = 0.38, P = 0.0103), ejection fraction (r = -0.39, P = 0.009), and serum N-terminal pro-brain natriuretic peptide levels (r = 0.48, P = 0.001), whereas the presence and segmental extent of LGE correlated only with LVEDD. In the 1-year follow-up cohort, the optimal cutoffs of T1 for predicting LV reverse remodeling (LVRR) and combined cardiac events (cardiac death, ventricular tachycardia/fibrillation, heart failure hospitalization) were 1366 ms and 1377 ms, respectively. In multivariate analysis, T1 < 1366 ms and T1 > 1377 ms remained significant predictors of LVRR (odds ratio, 11.3) and cardiac events (hazard ratio, 15.3), respectively, whereas the presence and segmental extent of LGE did not.T1 in patients with NIDCM experiencing recent HF may offer a promising strategy for assessing LV myocardial characteristics and predicting 1-year LVRR and cardiac events.
在非缺血性扩张型心肌病（NIDCM）中，心脏磁共振（CMR）上的心肌 T1 值（T1）的临床意义，特别是短期效用的证据很少。我们研究了 T1 评估左心室（LV）心肌特征并预测近期心力衰竭（HF）发作的 NIDCM 患者 1 年结局的潜力。45 例 NIDCM 合并 HF 症状的患者在 3 个月内行 CMR 检查，包括电影、非对比 T1 映射和晚期钆增强（LGE）。每位患者的 T1 定义为 LV 基底至心尖 5 个短轴切片的平均 T1 值。LGE 的外观通过视觉检查评估。T1 与 LV 舒张末期直径与身高的比值（LVEDD）相关（r = 0.38，P = 0.0103），与射血分数（r = -0.39，P = 0.009）和血清 N 末端脑利钠肽前体水平（r = 0.48，P = 0.001）相关，而 LGE 的存在和节段范围仅与 LVEDD 相关。在 1 年随访队列中，T1 预测 LV 逆重构（LVRR）和复合心脏事件（心脏死亡、室性心动过速/颤动、心力衰竭住院）的最佳截断值分别为 1366 ms 和 1377 ms。在多变量分析中，T1 < 1366 ms 和 T1 > 1377 ms 仍然是 LVRR（优势比，11.3）和心脏事件（危险比，15.3）的显著预测因素，而 LGE 的存在和节段范围则没有。近期 HF 发作的 NIDCM 患者的 T1 可能为评估 LV 心肌特征和预测 1 年 LVRR 和心脏事件提供一种很有前途的策略。
