Evaluation of Age-Related Interstitial Myocardial Fibrosis With Cardiac Magnetic Resonance Contrast-Enhanced T₁ Mapping

Objectives

This study sought to determine the relationship of cardiovascular magnetic resonance (CMR) measures of tissue composition to age in the Multi-Ethnic Study of Atherosclerosis (MESA).

Background

Animal and human studies have demonstrated increased collagen deposition in senescent hearts. New CMR indices of tissue composition by using T₁ mapping are sensitive to the presence of myocardial fibrosis.

Methods

A total of 1,231 study participants (51% women; age range 54 to 93 years) of the MESA cohort were evaluated with T₁ mapping by using 1.5-T CMR scanners. None of the participants had focal scar on delayed enhancement CMR. Single-slice T₁ mapping was performed at the midventricular level before and at 12- and 25-min delay after administration of gadolinium contrast by using a modified Look-Locker inversion recovery sequence. The partition coefficient was determined by the slope of the linear relationship of (1/T_1myo vs. 1/T_1blood). The extracellular volume fraction (ECV) was derived accounting for the hematocrit level. Multivariable regression analyses were performed, adjusting for traditional risk factors and left ventricular structure.

Results

Women had significantly greater partition coefficient, ECV, and precontrast T₁ than men, as well as lower post-contrast T₁ values (all p < 0.05). In general, linear regression analyses demonstrated that greater partition coefficient, pre-contrast T₁ values, and ECV were associated with older age in men (multivariate regression coefficients = 0.01; 5.9 ms; and 1.04% per 10 years' change; all p < 0.05). ECV was also significantly associated with age in women after multivariable adjustments.

Conclusions

CMR parameters that have been associated with myocardial fibrosis were related to older age in the MESA study. Women had higher ECV than men but less ECV change over time.