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Int J Cardiol Heart Vasc. 2019 Sep 7;25:100422. doi: 10.1016/j.ijcha.2019.100422. eCollection 2019 Dec.

Native T1 time and extracellular volume fraction in differentiation of normal myocardium from non-ischemic dilated and hypertrophic cardiomyopathy myocardium: A systematic review and meta-analysis.

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Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Department of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.



Both native T1 time and extracellular volume (ECV) fraction have been shown to be important measures for the detection of myocardial fibrosis. However, ECV determination requires the administration of an intravenous contrast agent, whereas native T1 mapping can be performed without a contrast agent.


Here, we conducted a meta-analysis of myocardial native T1 data obtained for non-ischemic cardiomyopathy (NIC) patients and controls. A literature review included studies that applied T1 mapping using modified Look-Locker inversion recovery to measure myocardial fibrosis, and the results were validated by comparing datasets for dilated cardiomyopathy (DCM) or hypertrophic cardiomyopathy (HCM) patients and healthy controls (HCs).


We identified 16 eligible studies. Pooled mean differences (MDs) and 95% confidence intervals (CIs) were estimated as follows. Native T1 at 1.5-T, DCM vs. HC: MD = 45.26 (95% CI: 30.92-59.59); HCM vs. HC: MD = 47.09 (95% CI: 32.42-61.76). Native T1 at 3.0-T, DCM vs. HC: MD = 82.52 (95% CI: 47.60-117.44); HCM vs. HC: MD = 115.87 (95% CI: 50.71-181.04). ECV at 1.5-T, DCM vs. HC: MD = 4.26 (95% CI: 3.06-5.46); HCM vs. HC: MD = 1.49 (95% CI: -1.45-4.43). ECV at 3.0-T, DCM vs. HC: MD = 8.40 (95% CI: 2.94-13.86); HCM vs. HC: MD = 8.02 (95% CI: 5.45-1-0.59).


In conclusion, native T1 values were significantly different between NIC patients and controls. Native T1 mapping may be a useful noninvasive method to detect diffuse myocardial fibrosis in NIC patients.


CI, confidence interval; CMR, cardiac magnetic resonance; DCM, dilated cardiomyopathy; Dilated cardiomyopathy; ECV, extracellular volume; Extracellular volume fraction; HC, healthy control; HCM, hypertrophic cardiomyopathy; Hypertrophic cardiomyopathy; LGE-MRI, late gadolinium-enhanced magnetic resonance imaging; MD, mean difference; MINORS, Methodological Index for Non-Randomized Studies; MOLLI, modified Look-Locker inversion recovery; Meta-analysis; NIC, non-ischemic cardiomyopathy; Native T1 mapping; SCD, sudden cardiac death; SD, standard deviation; Systematic review

Conflict of interest statement

Singo Kato's work has been funded by research grants from the MSD Life Science Foundation, Public Interest Incorporated Foundation, Japanese Circulation Society, and Japan Society for the Promotion of Science. The other authors declare no potential conflict of interest.

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