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| Item Type: | Article |
|---|---|
| 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, Rospleszcz, Susanne, Schuppert, Christopher, 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., Schulze, Matthias B., Greiser, Karin H., Brenner, Hermann, Mons, Ute, Decker, Josua A., Kröncke, Thomas, Küstner, Thomas, Nikolaou, Konstantin, Willich, Stefan N., Keil, Thomas, Dörr, Marcus, Bülow, Robin, Bamberg, Fabian, Pischon, Tobias ORCID: https://orcid.org/0000-0003-1568-767X, Schlett, Christopher L. and Schulz-Menger, Jeanette ORCID: https://orcid.org/0000-0003-3100-1092
|
| Abstract: | BACKGROUND: In cardiovascular magnetic resonance (CMR), myocardial native T(1) mapping enables quantitative, non-invasive tissue characterization and is sensitive to subclinical changes in myocardial structure and composition. However, data on the association between cardiometabolic risk and myocardial alterations are still limited. We therefore investigated how age, sex, and cardiometabolic risk factors are associated with myocardial T(1) as a potential imaging marker of myocardial target-organ involvement in a population-based analysis within the German National Cohort (NAKO). METHODS: This cross-sectional study included 29,573 prospectively enrolled participants who underwent midventricular T(1) mapping using 3.0 T CMR along with deep clinical phenotyping. After artificial intelligence-assisted myocardial segmentation, a subset of 9,162 outlier cases was subjected to manual quality control according to clinical evaluation standards. Cardiometabolic risk factors were identified through self-reported, physician-diagnosed medical history, clinical chemistry, and blood pressure measurements. Associations with myocardial T(1) were evaluated using multiple linear regression models adjusted for age, sex, heart rate, imaging site, and comorbidities. RESULTS: After quality control, 27,794 participants (12,401 [44.6%] women; 20–75 years) were included. Mean T(1) was overall higher in women (1,231 ± 33 ms) than in men (1,209 ± 34 ms), with differences progressively declining with age. The sex difference was confirmed in a healthy subcohort (n = 3,910), whilst age interaction was less pronounced. In adjusted analyses, T(1) was significantly higher in individuals with diabetes, kidney disease, and current smoking. Conversely, hyperlipidaemia was significantly associated with lower T(1). Associations with hypertension showed strongly sex-specific patterns: women had lower T(1) values, while T(1) increased with hypertension severity in men. CONCLUSIONS: Myocardial native T(1) varies by sex and age and shows distinct sex-specific associations with major cardiometabolic risk factors, supporting its role as a sensitive imaging marker of subtle myocardial alterations. Unexpectedly lower T(1) times in participants with hyperlipidaemia suggest a potential direct effect of blood lipids on the heart, which warrants further investigation. |
| Keywords: | German National Cohort (NAKO), T(1) Mapping, Cardiovascular Magnetic Resonance, Myocardium, Cardiometabolic, Cardiovascular Disease |
| Source: | Journal of Cardiovascular Magnetic Resonance |
| ISSN: | 1097-6647 |
| Publisher: | Elsevier / Society for Cardiovascular Magnetic Resonance |
| Page Range: | 102781 |
| Date: | 23 July 2026 |
| Official Publication: | https://doi.org/10.1016/j.jocmr.2026.102781 |
| PubMed: | View item in PubMed |
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