Non-invasive measurement of myocardial extracellular volume using T1 mapping as a novel biomarker of diffuse fibrosis in dilated cardiomyopathy

Background Diffuse myocardial fibrosis is frequently observed in histologies of dilated cardiomyopathy (DCM). T1-mapping techniques have the potential to measure fibrosis quantitatively and therefore provide novel cardiac magnetic resonance (CMR) insights into myocardial tissue characterization beyond the presently employed late gadolinium enhanced (LGE) techniques. Fibrosis results in expansion of the myocardial extracellular volume fraction (ECV). Recent reports indicate that T1-mapping calibrated by the blood hematocrit is a promising tool to non-invasively quantify ECV. We explored the clinical utility of this technique in a DCM cohort with different disease stages.