Native T1 reference values for nonischemic cardiomyopathies and populations with increased cardiovascular risk: A systematic review and meta-analysis

Maaike van den Boomen; Riemer H J A Slart; Enzo V Hulleman; Rudi A J O Dierckx; Birgitta K Velthuis; Pim van der Harst; David E Sosnovik; Ronald J H Borra; Niek H J Prakken

doi:10.1002/jmri.25885

Native T₁ reference values for nonischemic cardiomyopathies and populations with increased cardiovascular risk: A systematic review and meta-analysis

J Magn Reson Imaging. 2018 Apr;47(4):891-912. doi: 10.1002/jmri.25885. Epub 2017 Nov 13.

Authors

Maaike van den Boomen¹, Riemer H J A Slart², Enzo V Hulleman³, Rudi A J O Dierckx⁴, Birgitta K Velthuis⁵, Pim van der Harst⁶, David E Sosnovik⁷, Ronald J H Borra⁸, Niek H J Prakken³

Affiliations

¹ Department of Radiology, University of Groningen, University Medical Center Groningen, the Netherlands; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard-MIT Health Science and Technology, USA.
² Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, the Netherlands; Department of Biomedical Photonic Imaging, University of Twente, the Netherlands.
³ Department of Radiology, University of Groningen, University Medical Center Groningen, the Netherlands.
⁴ Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, the Netherlands.
⁵ Department of Radiology, University of Utrecht, University Medical Center Utrecht, the Netherlands.
⁶ Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands.
⁷ Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard-MIT Health Science and Technology, USA.
⁸ Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Netherlands; Medical Imaging Centre of Southwest Finland, Turku University Hospital, Finland.

Abstract

Background: Although cardiac MR and T₁ mapping are increasingly used to diagnose diffuse fibrosis based cardiac diseases, studies reporting T₁ values in healthy and diseased myocardium, particular in nonischemic cardiomyopathies (NICM) and populations with increased cardiovascular risk, seem contradictory.

Purpose: To determine the range of native myocardial T₁ value ranges in patients with NICM and populations with increased cardiovascular risk.

Study type: Systemic review and meta-analysis.

Population: Patients with NICM, including hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM), and patients with myocarditis (MC), iron overload, amyloidosis, Fabry disease, and populations with hypertension (HT), diabetes mellitus (DM), and obesity. FIELD STRENGTH/SEQUENCE: (Shortened) modified Look-Locker inversion-recovery MR sequence at 1.5 or 3T.

Assessment: PubMed and Embase were searched following the PRISMA guidelines.

Statistical tests: The summary of standard mean difference (SMD) between the diseased and a healthy control populations was generated using a random-effects model in combination with meta-regression analysis.

Results: The SMD for HCM, DCM, and MC patients were significantly increased (1.41, 1.48, and 1.96, respectively, P < 0.01) compared with healthy controls. The SMD for HT patients with and without left-ventricle hypertrophy (LVH) together was significantly increased (0.19, P = 0.04), while for HT patients without LVH the SMD was zero (0.03, P = 0.52). The number of studies on amyloidosis, iron overload, Fabry disease, and HT patients with LVH did not meet the requirement to perform a meta-analysis. However, most studies reported a significantly increased T₁ for amyloidosis and HT patients with LVH and a significant decreased T₁ for iron overload and Fabry disease patients.

Data conclusions: Native T₁ mapping by using an (Sh)MOLLI sequence can potentially assess myocardial changes in HCM, DCM, MC, iron overload, amyloidosis, and Fabry disease compared to controls. In addition, it can help to diagnose left-ventricular remodeling in HT patients.

Level of evidence: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:891-912.

Keywords: (Sh)MOLLI; cardiac risk populations; diffuse fibrosis; meta-analysis; native T1 mapping; nonischemic cardiomyopathy.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Cardiomyopathies / diagnostic imaging*
Cardiomyopathies / pathology
Cardiovascular Diseases / diagnostic imaging
Cardiovascular Diseases / pathology
Heart / diagnostic imaging
Humans
Magnetic Resonance Imaging / methods*
Myocardium / pathology
Reference Values
Risk Factors