Native T1 of noninfarcted myocardium was an independent predictor of all-cause mortality (chi-square = 21.7; p < 0.001) in patients with coronary artery disease.
Observational (n=665)
Yes
Does native T1 mapping of noninfarcted myocardium predict all-cause mortality and MACCE in patients with coronary artery disease?
Native T1 mapping of noninfarcted myocardium provides independent prognostic value for all-cause mortality and MACCE in patients with coronary artery disease, incremental to traditional risk factors like LVEF and LGE.
p-value: p=< 0.001
BACKGROUND: Coronary artery disease (CAD) remains the major cause of cardiac morbidity and mortality worldwide, despite the advances in treatment with coronary revascularization and modern antiremodeling therapy. Risk stratification in CAD patients is primarily based on left ventricular volumes, ejection fraction (LVEF), risk scores, and the presence and extent of late gadolinium enhancement (LGE). The prognostic role of T1 mapping in noninfarcted myocardium in CAD patients has not yet been determined. OBJECTIVES: This study sought to examine prognostic significance of native T1 mapping of noninfarcted myocardium in patients with CAD. METHODS: A prospective, observational, multicenter longitudinal study of consecutive patients undergoing routine cardiac magnetic resonance imaging with T1 mapping and LGE. The primary endpoint was all-cause mortality. Major adverse cardiocerebrovascular events (MACCE) (cardiac mortality, nonfatal acute coronary syndrome, stroke, and appropriate device discharge) are also reported. RESULTS: A total of 34 deaths and 71 MACCE (n = 665, males n = 424, median age interquartile range 57 22 years; 64%; median follow-up period of 17 11 months) were observed. Native T1 and extracellular volume were univariate predictors of outcome. Native T1 and LGE were stronger predictors of survival and MACCE compared with extracellular volume, LVEF, cardiac volumes, and clinical scores (p < 0.001). Native T1 of noninfarcted myocardium was the sole independent predictor of all-cause mortality (chi-square = 21.7; p < 0.001), which was accentuated in the absence of LGE or LVEF ≤35%. For MACCE, native T1 and LGE extent were joint independent predictors (chi-square = 25.6; p < 0.001). CONCLUSIONS: Characterization of noninfarcted myocardium by native T1 is an important predictor of outcome in CAD patients, over and above the traditional risk stratifiers. The current study's results provide a basis for a novel risk stratification model in CAD based on a complementary assessment of noninfarcted myocardium and post-infarction scar, by native T1 mapping and LGE, respectively.
“Using native T1 mapping, we can probably make an even better use of them, so that adverse consequences of CAD, such as heart failure or cardiac arrhythmia, may not need to occur.”
Püntmann et al. (2018) conducted an observational in Coronary artery disease (n=665). Native T1 mapping of noninfarcted myocardium was evaluated on all-cause mortality (p=< 0.001). Native T1 of noninfarcted myocardium was an independent predictor of all-cause mortality (chi-square = 21.7; p < 0.001) in patients with coronary artery disease.