Background: T1 mapping is an emerging tool in cardiovascular magnetic resonance (CMR) which may allow a quantification of myocardial damage without gadolinium administration.
Purpose: The aim of this prospective study was to compare the standard CMR parameters with T1 mapping in STEMI patients.
Subjects and methods: Consecutive patients (n= 42, mean age 58±5 years, 26 males) who underwent primary angioplasty for first STEMI. CMR studies (3T scanner) included steady state free precession, late gadolinium enhancement (LGE) and T1 mapping. Scan time with and without LGE was recorded. Left ventricular ejection fraction (LVEF), percentage (%) of LGE and % of microvascular obstruction (MVO) of LV mass were correlated with average T1 values.
Results: Scans were performed within an average of 5.4 days from admission. Average LVEF =54±13 %. Average LGE and MVO were 25±14 and 6.2±10, respectively. Average T1 was 1382±79 milliseconds. LVEF was strongly and negatively correlated with T1 values (p=0.005). Both LGE and MVO were strongly and positively correlated with T1 values (p=0.0003 and 0.03). Average scan length with and without LGE was 54±4 and 27±5 minutes, respectively. T1 map with corresponding LGE shown in the picture.
Conclusions: CMR using T1 mapping presents a new tool for STEMI evaluation. It allows accurate myocardial damage quantification obviating the need of intravenous gadolinium administration, permitting scan completion in 50% of standard scan time. This facilitates faster patient turnover, which is crucial in STEMI patients, as well as more efficient modality utilization.
