Clinical impact of native T1 mapping for detecting myocardial impairment in takotsubo cardiomyopathy

Yukio Aikawa, Teruo Noguchi, Yoshiaki Morita, Emi Tateishi, Atsushi Kono, Hiroyuki Miura, Yoshiaki Komori, Yasuhide Asaumi, Tetsuya Fukuda, Satoshi Yasuda

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Aims: To investigate the clinical impact of T1 mapping for detecting myocardial impairment in takotsubo cardiomyopathy (TTC) over time. Methods and results: In 23 patients with the apical ballooning type of TTC, the following 3T magnetic resonance (MR) examinations were performed at baseline and 3 months after TTC onset: T2-weighted imaging, T2 mapping, native T1 mapping, extracellular volume fraction (ECV), and late gadolinium enhancement. Eight healthy controls underwent the same MR examinations. Serial echocardiography was performed daily for ≥7 days and monthly until 3 months after onset. The median time from onset to MR examination was 7 days. During the acute phase, patients had, relative to controls, higher native T1 (1438 ± 162 vs. 1251 ± 90 ms, P < 0.001), ECV (35 ± 5% vs. 29 ± 4%, P < 0.001), and T2 (90 ± 34 vs. 68 ± 12 ms, P < 0.001) for the entire heart. Per-region analysis showed that higher native T1 and T2 in the basal region were correlated with lower left ventricular ejection fraction (r = -0.599, P = 0.004 and r = -0.598, P = 0.003, respectively). Receiver operator characteristic analysis showed that the area under the curve for native T1 (0.96) was significantly larger than that for T2 (0.86; P = 0.005) but similar to that for ECV (0.92; P = 0.104). At 3-month follow-up, native T1, ECV, and T2 in the apical region remained significantly elevated in all patients with TTC. The number of left ventricular (LV) segments with elevated native T1 (cut-off value 1339 ms) was significantly correlated with prolonged LV wall motion recovery time (r = 0.494, P = 0.027). Conclusion: Characterization of myocardium with native T1 mapping is a promising method for predicting LV wall motion restoration in TTC.

Original languageEnglish
Pages (from-to)1147-1155
Number of pages9
JournalEuropean heart journal cardiovascular Imaging
Issue number10
Publication statusPublished - 2019 Oct 1


  • Magnetic resonance imaging
  • T1 mapping
  • Takotsubo cardiomyopathy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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