Heart failure & cardiomyopathies
Prognostic Value of Myocardial T1 Mapping and Extracellular Volume Fraction in Heart Failure: A Meta-Analysis
Authors' conclusion
ECV has consistent prognostic implications across HF spectrum, regardless of HF types, clinical characteristics, and various etiology. Native T1 is less predictive than ECV, particularly in HF with preserved ejection fraction.
Study context
- Population
- Patients with heart failure (HF) (HFrEF and HFpEF)
- Participants
- 5,384 patients19 studies
- Comparison
- Native T1 and ECV as prognostic markers in HF
- Outcome
- Adverse outcomes:
- Mortality
- HF-related event
- Composite outcome
Pooled result
As reported in the abstract
Adverse outcomes:
- Mortality
- HF-related event
- Composite
- Higher native T1 in patients with vs without adverse outcomes, weighted MD
- 41.17 ms
- Higher ECV in patients with vs without adverse outcomes, weighted MD
- 4.73%
- HR per 1% increase in ECV
- 1.20 (95% CI 1.13-1.28)
- HR per >1% increase in ECV
- 1.56 (95% CI 1.40-1.75)
- HR ECV binary
- 2.62 (95% CI 2.07-3.32)
- HR per 1-ms increase in native T1
- 1.02 (95% CI 1.01-1.03)
- HR per ≥10-ms increase in native T1
- 1.08 (95% CI 1.05-1.11)
- HR native T1 binary
- 2.93 (95% CI 2.03-4.23)
Further pooled results
Native T1 in HFpEF (subgroup)
- Native T1 had no significant prognostic value in HFpEF
- P > 0.05
Higher-risk subgroups with abnormal T1 mapping
- Younger patients, NYHA III-IV, persistently increasing ECV, or negative late enhancement with abnormal T1 mapping at higher risk of adverse outcomes
Original publication
Prognostic Value of Myocardial T1 Mapping and Extracellular Volume Fraction in Heart Failure: A Meta-Analysis. JACC Cardiovasc Imaging. Published 29 August 2025. doi:10.
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