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| Item Type: | Preprint |
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| Title: | Myocardial native T1 mapping in the German National Cohort (NAKO): associations with age, sex, and cardiometabolic risk factors |
| Creators: |
Ammann, Clemens  ORCID: https://orcid.org/0000-0002-5962-4008, Gröschel, Jan ORCID: https://orcid.org/0000-0002-7268-9041, Saad, Hadil ORCID: https://orcid.org/0000-0001-8574-644X, Rospleszcz, Susanne ORCID: https://orcid.org/0000-0002-4788-2341, Schuppert, Christopher ORCID: https://orcid.org/0000-0002-9675-803X, Hadler, Thomas ORCID: https://orcid.org/0000-0002-6151-6858, Hickstein, Richard ORCID: https://orcid.org/0009-0009-7247-5076, Niendorf, Thoralf ORCID: https://orcid.org/0000-0001-7584-6527, Nolde, Janis M. ORCID: https://orcid.org/0000-0001-6864-8514, Schulze, Matthias B. ORCID: https://orcid.org/0000-0002-0830-5277, Greiser, Karin H. ORCID: https://orcid.org/0000-0003-3213-8285, Decker, Josua A. ORCID: https://orcid.org/0000-0001-6876-1373, Kröncke, Thomas ORCID: https://orcid.org/0000-0003-4889-1036, Küstner, Thomas ORCID: https://orcid.org/0000-0002-0353-4898, Nikolaou, Konstantin ORCID: https://orcid.org/0000-0003-2668-7325, Willich, Stefan N. ORCID: https://orcid.org/0009-0006-1270-2597, Keil, Thomas ORCID: https://orcid.org/0000-0002-9108-3360, Dörr, Marcus ORCID: https://orcid.org/0000-0001-7471-475X, Bülow, Robin ORCID: https://orcid.org/0000-0003-1884-5784, Bamberg, Fabian ORCID: https://orcid.org/0000-0002-7460-3942, Pischon, Tobias ORCID: https://orcid.org/0000-0003-1568-767X, Schlett, Christopher L. ORCID: https://orcid.org/0000-0002-1576-1481 and Schulz-Menger, Jeanette ORCID: https://orcid.org/0000-0003-3100-1092
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| Abstract: | BACKGROUND AND AIMS: In cardiovascular magnetic resonance (CMR), myocardial native T1 mapping enables quantitative, non-invasive tissue characterization and is sensitive to subclinical changes in myocardial structure and composition. We investigated how age, sex, and cardiometabolic risk factors are associated with myocardial T1 in a population-based analysis within the German National Cohort (NAKO). METHODS: This cross-sectional study included 29,573 prospectively enrolled participants who underwent CMR-based midventricular T1 mapping at 3.0 T, alongside clinical phenotyping. After artificial intelligence-assisted myocardial segmentation, a subset of 9,162 outliers was subjected to manual quality control according to clinical evaluation standards. Associations with cardiometabolic risk factors, identified through self-reported medical history, clinical chemistry, and blood pressure measurements, were evaluated using adjusted linear regression models. RESULTS: Women had higher T1 values than men, with sex differences progressively declining with age. T1 was significantly elevated in individuals with diabetes (β=3.91 ms; p<0.001), kidney disease (β=3.44 ms; p<0.001), and current smoking (β=6.67 ms; p<0.001). Conversely, hyperlipidaemia was significantly associated with lower T1 (β=−4.41 ms; p<0.001). Associations with hypertension showed a sex-specific pattern: T1 was lower in women but increased with hypertension severity in men. CONCLUSIONS: Myocardial native T1 varies by sex and age and shows associations with major cardiometabolic risk factors. Notably, lower T1 times in participants with hyperlipidaemia may indicate a direct effect of blood lipids on the heart. Our findings support the utility of T1 mapping as a sensitive marker of early myocardial changes and highlight the sex-specific interplay between cardiometabolic health and myocardial tissue composition. |
| Keywords: | German National Cohort (NAKO), T1 Mapping, Cardiovascular Magnetic Resonance, Myocardium, Cardiometabolic, Cardiovascular Disease |
| Source: | medRxiv |
| Publisher: | Cold Spring Harbor Laboratory Press |
| Article Number: | 2025.07.16.25331651 |
| Date: | 15 February 2026 |
| Official Publication: | https://doi.org/10.1101/2025.07.16.25331651 |
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