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Association of Myocardial T1/T2 Mapping Abnormalities With Late Gadolinium Enhancement and Left Ventricular Function
Yigit Can Kartal1, Muhammed Faruk Kazanbaş1, Mehmet Kadıoğlu1, Ali Fuat Tekin2, Hakan Ayyıldız1, Kadir Kasim Sahin3, Duygu Inan3, Sevil Tugrul Yavuz3, Alev Kılıçgedik3, Sercin Ozkok11Department of Radiology, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye2Department of Radiology, Johns Hopkins Medicine, Baltimore, MD, USA
3Department of Cardiology, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye
INTRODUCTION: To investigate the relationship between visually assessed myocardial late gadolinium enhancement (LGE), native T1/T2 mapping abnormalities, and left ventricular ejection fraction (LVEF) in a real-world adult cardiovascular magnetic resonance (CMR) cohort.
METHODS: This retrospective study included consecutive adults referred for clinical CMR with evaluable LGE. LGE presence (yes/no) was used as the comparative reference. Mapping abnormality was defined as elevated native T1 and/or T2 values using protocol-specific institutional reference limits derived from healthy controls (non-parametric upper reference limit; 95th percentile). Associations between LGE, mapping findings, and LVEF were assessed using univariable and multivariable logistic regression adjusted for age and LVEF.
RESULTS: A total of 1074 consecutive adult patients undergoing clinical CMR were screened. After predefined exclusions, 1005 patients in whom both late gadolinium enhancement and myocardial T1/T2 mapping were evaluable constituted the final analysis set. Myocardial LGE was present in 54.5%. Mapping abnormalities were strongly associated with LGE positivity (OR 8.61; 95% CI 6.05–12.26; p<0.001) and remained independently associated after multivariable adjustment for age and LVEF (adjusted OR 7.73; 95% CI 5.38–11.10; p<0.001). LGE-positive patients had lower LVEF than LGE-negative patients, and mapping abnormalities were also associated with lower LVEF. The mapping–LGE association persisted in both preserved and reduced LVEF strata.
DISCUSSION AND CONCLUSION: In a large heterogeneous adult CMR population, T1/T2 mapping abnormalities show a strong and independent association with visually assessed LGE and ventricular function, supporting mapping as a complementary component of integrated myocardial tissue characterization.
Keywords: Cardiovascular magnetic resonance, Late gadolinium enhancement, Myocardial T1 mapping, Myocardial T2 mapping, Myocardial tissue characterization, Left ventricular ejection fraction
Manuscript Language: English