Non-contrast T1 mapping characterizes the myocardium beyond that achieved by late gadolinium enhancement in both hypertrophic and dilated cardiomyopathy

Background Both HCM and DCM exhibit variable clinical outcomes. Unfortunately, our ability to risk stratify and characterize disease mechanisms in these patients remains poor, and improved biomarkers are needed. Myocardial fibrosis, both focal and diffuse, is a feature of both HCM and DCM and focal myocardial fibrosis, as assessed by LGE, has been recently identified as a predictor of cardiac death in HCM and DCM. We recently developed a novel method for non-contrast CMR T1 mapping, a recognized marker of increased water content such as in fibrotic tissue. We hypothesized that T1 mapping offers an alternative to late gadolinium enhancement (LGE) techniques, providing additional noninvasive diagnostic information in HCM and DCM.