Efficacy of Native T1 Mapping in differentiation between viable and non-viable myocardium in chronic ischemia

Abstract

Background Myocardial ischemia may lead to reversible or irreversible myocardial insult. A precise assessment of myocardial viability (MV) is of clinical relevance to determine the recovery potential of the affected segments. Contrast enhanced cardiac magnetic resonance (CE-CMR) with late gadolinium (Gd) sequences is the gold standard method for MV assessment. Our study tasted the accuracy of segmental native T1 mapping (NT1M) imaging as a non-contrast technique for assessing MV. Methods: Forty-three patients with chronic myocardial ischemia underwent 1.5 T CMR. Imaging protocol includes cine images to assess left ventricular (LV) function, and (LGE) images to detect and estimate the extension of myocardial enhancement (ME). Segments with > 75% enhancement were considered ischemic non-viable (INV). Segmental NT1M (modified Look-Locker inversion recovery MOLLI sequence 5(3)3) was obtained at basal, mid-ventricular and apical levels. Segmental native T1 mapping values (NT1MV) were analyzed and referred to the LGE results. Results This study included 688 myocardial segments, which were divided into healthy myocardium (HM) (No LGE)= 422 segments, ischemic viable myocardium (IVM) (LGE Conclusions Segmental NT1MV correlate well with the transmural (TM) extent of the myocardial scar, and distinguish between HM, IVM, and INVM.