The Prognostic Role of T1 Mapping Sequences: Can T1 Mapping Parameters Have a Role in Risk Stratification?

Abstract

Cardiovascular disease risk stratification and prognostication are very important for treatment planning. In addition, for a growing number of patients with overt symptomatic heart failure or asymptomatic but have structural heart disease, accurate risk stratification is essential. Conventional clinical cardiovascular risk factors, several biomarkers and echo-Doppler indexes are generally used to satisfy this need. However, non-invasive approaches to direct structural and tissue characterization of the myocardium have not produced satisfactory results. The recent development of the late gadolinium enhancement (LGE) imaging allows fibrosis or myocardial inflammation to be visualized. A growing body of evidence for LGE-based prognostication has been reported. However, not all patients with heart failure or at risk for it have been assessed with LGE. Moreover, the degree of diffuse fibrosis or inflammation cannot be easily quantified with LGE techniques. Recently, introduced T1 mapping-based quantification can provide the volume of extracellular space suggestive of the degree of diffuse tissue fibrosis or inflammation. Even without gadolinium contrast, native T1 values can provide quantitative information on myocardial tissue status. Here, we review current evidence for T1 mapping-based risk stratification and prognostication for various cardiac diseases that can lead to heart failure or lethal arrhythmic events.