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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2017;70:848-55 - Vol. 70 Num.10 DOI: 10.1016/j.rec.2017.02.018

Diagnostic and Prognostic Value of CMR T 1-Mapping in Patients With Heart Failure and Preserved Ejection Fraction

Karl-Philipp Rommel a, Christian Lücke b, Philipp Lurz a,

a Department of Internal Medicine/Cardiology, Heart Center, University of Leipzig, Leipzig, Germany
b Department of Radiology, University of Leipzig, Heart Center, Leipzig, Germany

Keywords

Cardiac magnetic resonance. Heart failure with preserved ejection fraction. Diastolic dysfunction. T1 mapping.

Abstract

Heart failure with preserved ejection fraction (HFpEF) presents a major challenge in modern cardiology. Although this syndrome is of increasing prevalence and is associated with unfavorable outcomes, treatment trials have failed to establish effective therapies. Currently, solutions to this dilemma are being investigated, including categorizing and characterizing patients more diversely to individualize treatment. In this regard, new imaging techniques might provide important information. Diastolic dysfunction is a diagnostic and pathophysiological cornerstone in HFpEF and is believed to be caused by systemic inflammation with the development of interstitial myocardial fibrosis and myocardial stiffening. Cardiac magnetic resonance (CMR) T1-mapping is a novel tool, which allows noninvasive quantification of the extracellular space and diffuse myocardial fibrosis. This review provides an overview of the potential of myocardial tissue characterization with CMR T1 mapping in HFpEF patients, outlining its diagnostic and prognostic implications and discussing future directions. We conclude that CMR T1 mapping is potentially an effective tool for patient characterization in large-scale epidemiological, diagnostic, and therapeutic HFpEF trials beyond traditional imaging parameters.

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1885-5857/© 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved