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Native T1 and ECV of noninfarcted myocardium and outcome in patients with coronary artery disease

Puntmann, VO, Carr-White, G, Jabbour, A, Yu, CY, Gebker, R, Kelle, S, Rolf, A, Zitzmann, S, Peker, E, D'Angelo, T, Pathan, F ORCID: 0000-0002-0939-5470, Elen, A, Valbuena, S, Hinojar, R, Arendt, C, Narula, J, Herrmann, E, Zeiher, AM and Nagel, E 2018 , 'Native T1 and ECV of noninfarcted myocardium and outcome in patients with coronary artery disease' , Journal of the American College of Cardiology, vol. 71, no. 7 , pp. 766-778 , doi: 10.1016/j.jacc.2017.12.020.

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Abstract

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 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.

Item Type: Article
Authors/Creators:Puntmann, VO and Carr-White, G and Jabbour, A and Yu, CY and Gebker, R and Kelle, S and Rolf, A and Zitzmann, S and Peker, E and D'Angelo, T and Pathan, F and Elen, A and Valbuena, S and Hinojar, R and Arendt, C and Narula, J and Herrmann, E and Zeiher, AM and Nagel, E
Keywords: T1 mapping, coronary artery disease, ischemic heart disease, outcome, remodeling
Journal or Publication Title: Journal of the American College of Cardiology
Publisher: Elsevier Science Inc
ISSN: 0735-1097
DOI / ID Number: 10.1016/j.jacc.2017.12.020
Copyright Information:

Copyright 2018 The American College of Cardiology Foundation

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