Prognostic Role of T1 Mapping Parameters in Ischemic and Non-Ischemic Cardiomyopathies: A Systematic Review and Metaanalysis

Abstract

Introduction T1 mapping is a novel cardiac magnetic resonance (CMR) based technique for characterization of myocardial tissue. Extracellular volume (ECV) fraction represents estimation of myocardial extracellular space and is useful for evaluation and quantification of myocardial fibrosis. However, their role in prognosis and assessing outcomes in cardiovascular diseases has not been well described. Methods We performed a systematic review and metaanalysis evaluating the prognostic role of T1 mapping parameters in patients in patients with ischemic and non-ischemic cardiomyopathies. PubMed, Embase, Cochrane Central databases were searched from inception to Feb 2019 for relevant studies. Primary outcome measure was combined endpoint of death or adverse cardiovascular events (including cardiovascular death/hospitalization for heart failure). Hazard Ratios (HR) from included studies were pooled in metaanalysis using random effect model. Results 5 studies with 1462 participants were included in the analysis. Mean age was 62.3 years, 46.9% of participants were females and mean follow up period was 16.3 months. Of these, 43.6% (637) had non-ischemic cardiomyopathy and heart failure, 32.9% (481) had heart failure, 6.4% (94) had valvular heart disease, 3.8% (55) had coronary artery disease and 5.3% (78) had other cardiac diseases. We found that higher ECV was associated with increased risk for combined outcome of death or adverse cardiovascular events (HR-1.09, 95% CI (1.05-1.14), P Conclusion ECV has independent prognostic value and can help in risk stratification of patients with ischemic and non-ischemic cardiomyopathies.