Multiparametric Differentiation of Idiopathic Dilated Cardiomyopathy With and Without Congestive Heart Failure by Means of Cardiac and Hepatic T1-Weighted MRI Mapping.

Abstract

OBJECTIVE. The purpose of this study was to test the hypothesis that patients with idiopathic dilated cardiomyopathy (IDCM) and heart failure have increased liver T1 relaxation times at MRI owing to congestion compared with the T1 relaxation times in patients with IDCM without heart failure and healthy control subjects. MATERIALS AND METHODS. For this retrospective cross-sectional study, 55 subjects (33 men, 22 women; mean age, 47 ± 15 years) who had undergone cardiac MRI were included: 20 healthy control subjects and 35 consecutively registered patients with IDCM. Twenty-one patients were hospitalized for acute heart failure, and 14 patients were in stable condition without heart failure. The performances of cardiac volume, left ventricular (LV) longitudinal strain, and ejection fraction (LVEF) in differentiating IDCM with and without heart failure were compared with myocardial and liver T1 relaxation times by means of Mann-Whitney U test and ROC analysis. RESULTS. The native T1 relaxation time of myocardium was significantly greater in patients with IDCM than in healthy control subjects (p < 0.001) but could not be used to differentiate between IDCM with and IDCM without heart failure (p = 0.653). Conversely, the native T1 relaxation time of liver was significantly greater in patients with IDCM and heart failure than in those without heart failure (p < 0.001). Native T1 relaxation time of liver was the overall best parameter for identifying the presence of heart failure in patients with IDCM (AUC, 0.96). It performed better than LVEF (AUC, 0.88) and global longitudinal LV strain (AUC, 0.85). CONCLUSION. Native T1 relaxation time of liver is an easily accessible and accurate noninvasive imaging marker of congestive heart failure in patients with IDCM. It can be measured on standard short-axis cardiac MRI T1-weighted maps and facilitates differentiating patients with IDCM with from those without heart failure more accurately than established functional parameters, such as LV volume, LVEF, and LV strain.