Interstitial fibrosis of LV is a hallmark of primary hypertrophic cardiomyopathy (HCM) with an eightfold greater amount of plexiform fibrosis encasing myocytes. Novel T1mapping MR sequences can quantify more subtle changes in the amount of interstitial collagen besides late gadolinium enhancement (LGE). We compared T1mapping without and with contrast agent to identify myocardial fibrosis in HCM. We studied 20 HCM patients (51±17 yrs), 10 normals (N) (42±9 yrs), and 5 first degree relatives of HCM (HCMR) (24±9 yrs p<0.05 vs HCM and N). CMR was performed on a 1.5 Tesla scanner (Siemens). Short axis SSFP cine images of LV were acquired; image position was used for T1-mapping and late gadolinium enhancement (LGE). MOLLI T1 maps were generated from 5-7 SSFP images with variable inversion preparation time before and after gadobutrol i.v. (0.15 mmol/kg). Region of interest were drawn on 3 short axis average T1 values (msec) were fitted by a non-linear curve. Systolic function was similar between groups, LV Mass Index and IV septum were larger in HCM. In HCM pre -contrast T1 was significantly longer. The ratio pre T1/post T1 was significantly greater in HCM (see Table). In HCM T1 pre-contrast was higher in IVS 1007±35 vs 991±53 (P = 0.011) and in segments with LGE than in those without (HCM with LGE 1003±31 ms no LGE 955±19 ms, P<0.001). In segments unaffected by LGE and of normal thickness T1 values were significantly higher than N and HCMR (P<0.001). View this table: Table 1 In HCM noncontrast T1 mapping detects underlying disease also in segments negative to LGE. In HCMR phenotype negative noncontrast T1 mapping values are comparable to N. This magnetic resonance tool has the potential to become a useful marker in the early detection, monitoring and risk-stratification of hypertrophic cardiomyopathy.