Native T₁ value in the remote myocardium is independently associated with left ventricular dysfunction in patients with prior myocardial infarction

Abstract

Purpose To compare remote myocardium native T1 in patients with chronic myocardial infarction (MI) and controls without MI and to elucidate the relationship of infarct size and native T1 in the remote myocardium for the prediction of left ventricular (LV) systolic dysfunction after MI. Materials and Methods A total of 41 chronic MI (18 anterior MI) patients and 15 age-matched volunteers with normal LV systolic function and no history of MI underwent cardiac MR at 1.5 T. Native T1 map was performed using a slice interleaved T1 mapping and late gadolinium enhancement (LGE) imaging. Cine MR was acquired to assess LV function and mass. Results The remote myocardium native T1 time was significantly elevated in patients with prior MI, compared to controls, for both anterior MI and non-anterior MI (anterior MI:1099 ± 30, non-anterior MI:1097 ± 39, controls:1068 ± 25 msec, P <0.05). Remote myocardium native T1 moderately correlated with LV volume, mass index and ejection fraction (r=0.38, 0.50, −0.49, respectively, all p <0.05). LGE infarct size had a moderate correlation with reduced LV ejection fraction (r=−0.33, p<0.05), but there was no significant association between native T1 and infarct size. Native T1 time in the remote myocardium was independently associated with reduced LV ejection fraction, after adjusting for age, gender, infarct size and comorbidity (β=−0.34, p=0.03). Conclusion In chronic MI, the severity of LV systolic dysfunction after MI is independently associated with native T1 in the remote myocardium. Diffuse myocardial fibrosis in the remote myocardium may play an important pathophysiological role of post-MI LV dysfunction.

Cardiac MR Characterization of left ventricular remodeling in a swine model of infarct followed by reperfusion

“…An increase in the native T 1 in infarcted tissue is observed in the early months following MI in clinical studies and experimental models . Increased myocardial native T1 has also been shown in patients with nonischemic dilated cardiomyopathy with complex ventricular arrhythmia . In our study there was a progressive increase in the native T 1 of infarcted myocardium, with a gradual diminution in the infarct core size.…”

Role of Cardiac Magnetic Resonance to Improve Risk Prediction following Acute ST-elevation Myocardial Infarction

“…In this regard, T1 mapping may be particularly useful to characterize abnormalities in myocardial tissue regions not directly affected by ischemia/reperfusion injury. Remote myocardium T1 values are significantly higher in patients with prior myocardial infarction compared to controls [117]. In addition, the severity of LV systolic dysfunction is independently related with T1 times derived from native T1 mapping.…”

Cardiac magnetic resonance T1 mapping. Part 2: Diagnostic potential and applications

“…Compared with LE imaging, ECV mapping was shown to more accurately assess acute infarction size, which is typically overestimated by LE [13]. Beyond evaluation of myocardium involved in AMI, increased native T1 and ECV values of normal-appearing, remote myocardium were found to independently predict all-cause mortality and major cardiac events after AMI better than any other functional or morphological CMR index [14][15][16][17][18].…”