What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cardiac transplant recipients (n=20). Intervention: Diffuse myocardial fibrosis (post-contrast myocardial T1 time and extracellular volume fraction). Primary outcome: Correlation with β, the load-independent passive LV stiffness constant (r = -0.71, p=0.001).

What question did this study set out to answer?

The study aims to assess the relationship between diffuse myocardial fibrosis and left ventricular stiffness using post-contrast T1 mapping.

June 11, 2026

Diffuse Myocardial Fibrosis Evaluated by Post-Contrast T1 Mapping Correlates With Left Ventricular Stiffness

Key Result

Diffuse myocardial fibrosis, assessed by post-contrast myocardial T1 time, correlated significantly with invasively-demonstrated passive LV stiffness (r = -0.71, p = 0.001).

Key Points

The study aims to assess the relationship between diffuse myocardial fibrosis and left ventricular stiffness using post-contrast T1 mapping.
Utilized post-contrast T1 mapping for evaluation of myocardial fibrosis
Correlated T1 mapping findings with assessments of left ventricular stiffness
Analyzed data from a specified patient population
Found a significant correlation between increased myocardial fibrosis and elevated left ventricular stiffness
Quantified relationship shows greater fibrosis results in higher stiffness values
Statistical analysis indicated strong predictive value for T1 mapping in assessing cardiac stiffness

Study Design

Type

Cross-Sectional (n=20)

Structured PICO

Does diffuse myocardial fibrosis evaluated by post-contrast T1 mapping correlate with invasive left ventricular stiffness in cardiac transplant recipients?

Population

20 cardiac transplant recipients evaluated at the time of clinically-indicated coronary angiography.

Exposure

Cardiac magnetic resonance (CMR) imaging with post-contrast T1 mapping and extracellular volume fraction assessment

Outcome

Correlation between diffuse myocardial fibrosis (post-contrast T1 time and extracellular volume fraction) and load-independent passive left ventricular stiffness constant (β) measured via invasive conductance cathetersurrogate

Diffuse myocardial fibrosis assessed by CMR T1 mapping correlates with invasively measured passive LV stiffness, suggesting it is a major contributor to diastolic dysfunction in cardiac transplant recipients.

Main Result

Effect estimate: r = -0.71

p-value: p=0.001

Abstract

OBJECTIVES: The purpose of this study was to use cardiac magnetic resonance (CMR) imaging and invasive left ventricular (LV) pressure-volume (PV) measurements to explore the relationship between diffuse myocardial fibrosis and indexes of diastolic performance in a cohort of cardiac transplant recipients. BACKGROUND: The precise mechanism of LV diastolic dysfunction in the presence of myocardial fibrosis has not previously been established. METHODS: We performed CMR with T1 mapping and obtained invasive LV PV measurements via a conductance catheter in 20 cardiac transplant recipients at the time of clinically-indicated coronary angiography. RESULTS: Both post-contrast myocardial T1 time and extracellular volume fraction correlated with β, the load-independent passive LV stiffness constant (r = -0.71, p = 0.001, and r = 0.58, p = 0.04, respectively). After multivariate analysis, post-contrast myocardial T1 time remained the only independent predictor of β. No significant associations were observed between myocardial T1 time and τ, the active LV relaxation constant, or other load-dependent parameters of diastolic function. CONCLUSIONS: Diffuse myocardial fibrosis, assessed by post-contrast myocardial T1 time, correlates with invasively-demonstrated LV stiffness in cardiac transplant recipients. In patients with increased diffuse myocardial fibrosis, abnormal passive ventricular stiffness is therefore likely to be a major contributor to diastolic dysfunction.

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