Heart failure & cardiomyopathiesDiagnostic or prognostic study
Native T1 for Diagnosis and Risk Prediction in Amyloid Transthyretin Cardiomyopathy
- Diagnostic accuracy and prognostic cohort study
- single-centre
- national referral amyloidosis centre
Authors' conclusion
Native T1 can provide pragmatic diagnostic supportive thresholds, whereas ECV-calibrated native T1 strata reproduced a graded 3-year mortality risk.
Study context
- Population
- Individuals undergoing cardiac magnetic resonance (CMR) for suspected or confirmed transthyretin amyloidosis at a national referral amyloidosis centre, 2011–2025
- Participants
- 1,675 individuals
- Comparison
- Native T1 vs extracellular volume (ECV) for diagnosis and risk stratification
- Asymptomatic TTR-variant carriersn = 125
- Extracardiac ATTRn = 44
- Early ATTR-CMn = 73
- Overt ATTR-CMn = 1,433
- Outcome
- Diagnostic targets: any cardiac involvement (early/overt ATTR-CM); overt vs early ATTR-CM; prognostic: all-cause mortality
Performance
As reported in the abstract
Diagnostic performance of native T1
Native T1 ≤1,050 ms (z-score +1.14): low likelihood of cardiac involvement, sensitivity
93%
Native T1 ≤1,050 ms (z-score +1.14): low likelihood of cardiac involvement, specificity
84%
Native T1 ≥1,100 ms (z-score +2.40): overt ATTR-CM, sensitivity
75%
Native T1 ≥1,100 ms (z-score +2.40): overt ATTR-CM, specificity
88%
Further findings
Correlation of native T1 with ECV
- Correlation (r), weaker coupling in advanced disease
- 0.62
All-cause mortality · median 3.3 years
- Deaths
- 822 of 1,675 (49%)
- ECV-calibrated native T1 risk categories reproduced a stepwise 3-year mortality gradient; native T1 strata improved prognostic information beyond clinical variables
Original publication
Native T1 for Diagnosis and Risk Prediction in Amyloid Transthyretin Cardiomyopathy. JACC Cardiovasc Imaging. Published 24 September 2026. doi:10.1016/j.jcmg.2026.07.026
Summarised from the published abstract; every number is checked against it