Iwakawa Hidehiro, Suzuki Nobuhiro, Yoshida Hirokazu, Sasaki Yohei, Kato Ryosuke, Kaimori Ryota, Watanabe Hiroyuki
Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, 1-1-1, Hondoh, Akita 010-8543, Japan.
Central Radiology Division, Akita University Hospital, 1-1-1, Hondoh, Akita 010-8543, Japan.
Int J Cardiol Heart Vasc. 2025 Aug 29;61:101787. doi: 10.1016/j.ijcha.2025.101787. eCollection 2025 Dec.
The clinical utility and optimal analytical approach for native T1 mapping in cardiac sarcoidosis (CS) remain unclear. This study investigated the clinical value of segmental native T1 assessment in patients with CS.
We recruited 55 participants, including 41 patients undergoing diagnostic evaluation of CS and 14 healthy controls. Of the 41 patients, 29 were diagnosed with CS and 12 were classified as non-CS. Segmental cardiac magnetic resonance findings of the left ventricle were evaluated using a 1.5-T scanner. The primary endpoint was a composite of all-cause death, fatal ventricular arrhythmia, bradycardia, or hospitalization for cardiovascular events.
Maximum and global native T1 values were significantly higher in CS patients than in healthy controls and non-CS patients. Maximum and global T1 values demonstrated comparable predictive performance in differentiating CS from the other groups, with areas under the curve (AUCs) of 0.92 and 0.90, respectively. The AUC for predicting segments with late gadolinium enhancement (LGE) was highest for extracellular volume, followed by native T1 and T2 ( < 0.05 for all). Patients with six or more segments showing native T1 ≥ 1091 ms had a significantly worse prognosis than those without (55.6 % vs. 18.2 %, = 0.028).
Maximum and global native T1 values were highly predictive for differentiating CS. The high segmental native T1 values in patients with CS may reflect the regional presence of LGE. Segmental native T1 assessment can aid in estimating long-term outcomes.
心脏结节病（CS）中，天然T1映射的临床效用及最佳分析方法仍不明确。本研究调查了CS患者节段性天然T1评估的临床价值。
我们招募了55名参与者，包括41名接受CS诊断评估的患者和14名健康对照者。在41名患者中，29名被诊断为CS，12名被归类为非CS。使用1.5-T扫描仪评估左心室的节段性心脏磁共振成像结果。主要终点是全因死亡、致命性室性心律失常、心动过缓或心血管事件住院的综合结果。
CS患者的最大和整体天然T1值显著高于健康对照者和非CS患者。最大和整体T1值在区分CS与其他组方面表现出相似的预测性能，曲线下面积（AUC）分别为0.92和0.90。预测钆延迟增强（LGE）节段的AUC，细胞外容积最高，其次是天然T1和T2（所有P<0.05）。有6个或更多节段显示天然T1≥1091 ms的患者预后明显比无此情况的患者差（55.6%对18.2%，P = 0.028）。
最大和整体天然T1值对区分CS具有高度预测性。CS患者节段性天然T1值高可能反映了LGE的区域存在。节段性天然T1评估有助于估计长期预后。
