Native T1 Mapping in Non-Ischaemic Cardiomyopathy Using 3.0 Tesla MRI: A Single Centre Study

Abstract

INTRODUCTION: Heart failure is a global concern, with non-ischaemic cardiomyopathy (NICMP) contributing significantly. Myocardial fibrosis is a hallmark feature, and early detection is crucial for management and prognosis. Endomyocardial biopsy is the gold standard but invasive. Cardiac MRI offers a non-invasive alternative; however, late gadolinium enhancement (LGE) is limited in detecting diffuse fibrosis and unsuitable for chronic kidney disease. Native T1 mapping enhances tissue characterization. This study evaluates native T1 values in NICMP patients, comparing them with published reference values and LGE findings. MATERIALS AND METHODS: This retrospective study analysed 34 NICMP patients who underwent 3.0T cardiac MRI between January 2021 and October 2023. Mid-ventricular septal native T1 values were measured by two blinded readers and compared to a normal reference (1097 ms). Statistical analysis included one-sample T-tests for reference comparison and independent T-tests for differences between LGE-positive and LGE-negative groups. Inter-observer agreement was assessed using the intraclass correlation coefficient (ICC). RESULTS: The cohort (mean age 45.09 years) showed a mean native T1 value of 1307.97 ± 68.99ms, significantly higher than the reference (p<0.001). Inter-observer agreement was excellent (ICC: 0.98). Twelve patients (35.3%) were LGE-positive. No significant difference in native T1 values was observed between LGE-negative (1291.68 ms) and LGE-positive (1337.83 ms) groups. CONCLUSION: Native T1 values are significantly elevated in NICMP, potentially detecting diffuse fibrosis missed by LGE. T1 mapping shows promise as a non-invasive, gadolinium-free tool for diagnostic assessment and may contribute to risk stratification. Larger studies are needed to establish local reference values and validate these findings.