Native T1 mapping showed significantly increased T1 values in patients with HCM (SMD 1.41), DCM (SMD 1.48), and myocarditis (SMD 1.96) compared with healthy controls (P<0.01).
Meta-Analysis
Does native T1 mapping using an (Sh)MOLLI sequence differentiate patients with nonischemic cardiomyopathies and increased cardiovascular risk from healthy controls?
Native T1 mapping can assess myocardial changes in various nonischemic cardiomyopathies and help diagnose left-ventricular remodeling in hypertensive patients.
Effect estimate: SMD 1.41 (HCM), 1.48 (DCM), 1.96 (MC)
p-value: p=<0.01
Background Although cardiac MR and T 1 mapping are increasingly used to diagnose diffuse fibrosis based cardiac diseases, studies reporting T 1 values in healthy and diseased myocardium, particular in nonischemic cardiomyopathies (NICM) and populations with increased cardiovascular risk, seem contradictory. Purpose To determine the range of native myocardial T 1 value ranges in patients with NICM and populations with increased cardiovascular risk. Study Type Systemic review and meta‐analysis. Population Patients with NICM, including hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM), and patients with myocarditis (MC), iron overload, amyloidosis, Fabry disease, and populations with hypertension (HT), diabetes mellitus (DM), and obesity. Field Strength/Sequence (Shortened) modified Look–Locker inversion‐recovery MR sequence at 1.5 or 3T. Assessment PubMed and Embase were searched following the PRISMA guidelines. Statistical Tests The summary of standard mean difference (SMD) between the diseased and a healthy control populations was generated using a random‐effects model in combination with meta‐regression analysis. Results The SMD for HCM, DCM, and MC patients were significantly increased (1.41, 1.48, and 1.96, respectively, P < 0.01) compared with healthy controls. The SMD for HT patients with and without left‐ventricle hypertrophy (LVH) together was significantly increased (0.19, P = 0.04), while for HT patients without LVH the SMD was zero (0.03, P = 0.52). The number of studies on amyloidosis, iron overload, Fabry disease, and HT patients with LVH did not meet the requirement to perform a meta‐analysis. However, most studies reported a significantly increased T 1 for amyloidosis and HT patients with LVH and a significant decreased T 1 for iron overload and Fabry disease patients. Data Conclusions Native T 1 mapping by using an (Sh)MOLLI sequence can potentially assess myocardial changes in HCM, DCM, MC, iron overload, amyloidosis, and Fabry disease compared to controls. In addition, it can help to diagnose left‐ventricular remodeling in HT patients. Level of Evidence: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:891–912.
Boomen et al. (Mon,) conducted a meta-analysis in Nonischemic cardiomyopathies and populations with increased cardiovascular risk. Native T1 mapping using (Sh)MOLLI sequence vs. Healthy controls was evaluated on Standard mean difference (SMD) of native myocardial T1 values (SMD 1.41 (HCM), 1.48 (DCM), 1.96 (MC), p=<0.01). Native T1 mapping showed significantly increased T1 values in patients with HCM (SMD 1.41), DCM (SMD 1.48), and myocarditis (SMD 1.96) compared with healthy controls (P<0.01).