William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London, Charterhouse Square, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom.
Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
JACC Cardiovasc Imaging. 2023 Apr;16(4):450-460. doi: 10.1016/j.jcmg.2022.06.011. Epub 2022 Sep 14.
BACKGROUND: Cardiac magnetic resonance native T1-mapping provides noninvasive, quantitative, and contrast-free myocardial characterization. However, its predictive value in population cohorts has not been studied. OBJECTIVES: The associations of native T1 with incident events were evaluated in 42,308 UK Biobank participants over 3.17 ± 1.53 years of prospective follow-up. METHODS: Native T1-mapping was performed in 1 midventricular short-axis slice using the Shortened Modified Look-Locker Inversion recovery technique (WIP780B) in 1.5-T scanners (Siemens Healthcare). Global myocardial T1 was calculated using an automated tool. Associations of T1 with: 1) prevalent risk factors (eg, diabetes, hypertension, and high cholesterol); 2) prevalent and incident diseases (eg, any cardiovascular disease [CVD], any brain disease, valvular heart disease, heart failure, nonischemic cardiomyopathies, cardiac arrhythmias, atrial fibrillation [AF], myocardial infarction, ischemic heart disease [IHD], and stroke); and 3) mortality (eg, all-cause, CVD, and IHD) were examined. Results are reported as odds ratios (ORs) or HRs per SD increment of T1 value with 95% CIs and corrected P values, from logistic and Cox proportional hazards regression models. RESULTS: Higher myocardial T1 was associated with greater odds of a range of prevalent conditions (eg, any CVD, brain disease, heart failure, nonischemic cardiomyopathies, AF, stroke, and diabetes). The strongest relationships were with heart failure (OR: 1.41 [95% CI: 1.26-1.57]; P = 1.60 × 10) and nonischemic cardiomyopathies (OR: 1.40 [95% CI: 1.16-1.66]; P = 2.42 × 10). Native T1 was positively associated with incident AF (HR: 1.25 [95% CI: 1.10-1.43]; P = 9.19 × 10), incident heart failure (HR: 1.47 [95% CI: 1.31-1.65]; P = 4.79 × 10), all-cause mortality (HR: 1.24 [95% CI: 1.12-1.36]; P = 1.51 × 10), CVD mortality (HR: 1.40 [95% CI: 1.14-1.73]; P = 0.0014), and IHD mortality (HR: 1.36 [95% CI: 1.03-1.80]; P = 0.0310). CONCLUSIONS: This large population study demonstrates the utility of myocardial native T1-mapping for disease discrimination and outcome prediction.
背景：心脏磁共振 T1 mapping 可提供无创、定量、对比剂-free 的心肌特征。然而，其在人群队列中的预测价值尚未得到研究。
目的：在 UK Biobank 的 42,308 名参与者中，通过 3.17 ± 1.53 年的前瞻性随访，评估了 T1 与发病事件的相关性。
方法：使用 Shortened Modified Look-Locker Inversion recovery 技术（WIP780B）在 1.5-T 扫描仪（西门子医疗）中对 1 个中隔短轴切片进行 T1-mapping。使用自动工具计算整体心肌 T1 值。T1 值与以下方面的相关性进行了评估：1）现患危险因素（如糖尿病、高血压和高胆固醇）；2）现患和发病疾病（如任何心血管疾病[CVD]、任何脑部疾病、瓣膜性心脏病、心力衰竭、非缺血性心肌病、心律失常、心房颤动[AF]、心肌梗死、缺血性心脏病[IHD]和中风）；以及 3）死亡率（如全因、CVD 和 IHD）。结果以 T1 值每增加 1 个标准差的比值比（OR）或 HR 表示，并伴有 95%置信区间和校正后的 P 值，来自逻辑和 Cox 比例风险回归模型。
结果：心肌 T1 值较高与多种现患疾病的几率增加有关（如任何 CVD、脑部疾病、心力衰竭、非缺血性心肌病、AF、中风和糖尿病）。与心力衰竭（OR：1.41[95%CI：1.26-1.57]；P = 1.60×10）和非缺血性心肌病（OR：1.40[95%CI：1.16-1.66]；P = 2.42×10）的相关性最强。T1 值与发病性 AF（HR：1.25[95%CI：1.10-1.43]；P = 9.19×10）、发病性心力衰竭（HR：1.47[95%CI：1.31-1.65]；P = 4.79×10）、全因死亡率（HR：1.24[95%CI：1.12-1.36]；P = 1.51×10）、CVD 死亡率（HR：1.40[95%CI：1.14-1.73]；P = 0.0014）和 IHD 死亡率（HR：1.36[95%CI：1.03-1.80]；P = 0.0310）均呈正相关。
结论：这项大型人群研究表明，心肌 T1 映射可用于疾病鉴别和预后预测。
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