Key result
CMR T1 mapping fails to identify prevalent cardiac mechanical dysfunction in transfusion-dependent β-thalassemia.
Why the study?
There is a gap in evidence regarding the independent role of CMR T1 mapping in identifying early myocardial dysfunction in transfusion-dependent β-thalassemia patients with normal T2 values.
Does reduced CMR T1 mapping correlate with early echocardiographic signs of mechanical dysfunction in transfusion-dependent β-thalassemia patients with normal T2?
Observational (n=154)
No
Does reduced CMR T1 mapping correlate with early echocardiographic signs of mechanical dysfunction in transfusion-dependent β-thalassemia patients with normal T2?
In transfusion-dependent β-thalassemia patients with normal T2, reduced T1 mapping displays a weak correlation with echocardiographic parameters of mechanical dysfunction but does not provide significant incremental value in identifying a higher prevalence of cardiac impairment.
Answers are grounded in this paper and cite their sources.
Does not improve identification of mechanical dysfunction in normal-T2 thalassemia; leaves open T1 mapping value for early detection.
BACKGROUND: A T2* ≤20 ms in cardiovascular magnetic resonance (CMR) sequences suggests the presence of iron overload cardiomyopathy in patients with transfusion-dependent β-thalassemia (TDT). However, there is still a gap in evidence regarding the independent role of T1 mapping in identifying early myocardial dysfunction. The aim of this study is to investigate the role of T1 mapping in identifying early cardiac mechanical dysfunction in TDT patients with normal T2* values. METHODS: About 154 consecutive TDT patients with T2* >20 ms were enrolled and stratified by reduced (≤955 ms) or normal (>955 ms) T1 mapping values. CMR T1 mapping and speckle tracking echocardiography (STE) indices were evaluated. The primary endpoint was the correlation between T1 mapping and STE indices. The secondary endpoint was the prevalence of cardiac mechanical dysfunction between patients with reduced or normal T1 mapping. RESULT: T1 mapping showed statistically significant correlations with global longitudinal strain (GLS, r = -0.19, p = 0.01), global work index (GWI, r = 0.15, p = 0.04), global constructive work (GCW, r = 0.18, p = 0.02), and peak atrial longitudinal strain (PALS, r = 0.2, p<0.01). The prevalence of cardiac mechanical dysfunction was low, without any difference between patients with reduced or normal T1 mapping. CONCLUSIONS: In TDT patients with normal T2*, T1 mapping demonstrated a weak but significant correlation with echocardiographic indices of cardiac mechanics. The prevalence of cardiac mechanical dysfunction was low without any difference between those with reduced or normal T1 mapping.
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Marchini et al. (2026) conducted an observational in Transfusion-dependent β-thalassemia with normal T2 (n=154). T1 mapping values was evaluated on Correlation between T1 mapping and echocardiographic indices of cardiac mechanics (e.g., Global Longitudinal Strain) (r = -0.19, p=0.01). In transfusion-dependent β-thalassemia patients with normal T2, T1 mapping demonstrated a weak but significant correlation with global longitudinal strain without providing incremental benefit in identifying prevalent cardiac mechanical dysfunction.
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