Vol. 6, Issue 2, Part B (2024)

Background: Ischemic cardiomyopathy continues to be a principal contributor to early morbidity and mortality. The formation of myocardial scar tissue, secondary to ischemic events, is linked with alterations in ventricular remodeling. The aim of the current study is to investigate the native T1 mapping and late gadolinium enhancement (LGE) to identify myocardial fibrosis in patients with ischemic cardiomyopathy.
Methods: This prospective center study was conducted on 87 patients that proved to have ischemic cardiomyopathy who were admitted to Benha University Hospital& national heart institute (NHI), Egypt from March 2022 to April 2023. Patients were subjected to a CMR viability evaluation, which included an analysis of ventricular function alongside an assessment of LGE for the identification of myocardial fibrosis and T1 mapping procedures. Also, 2D speckle tracking & GLS were done for all patients. 
Results: The mean T1 mapping among patients with Late gadolinium enhancement was higher compared with patients who didn’t show Late gadolinium enhancement (1131.7 Vs 983.0 respectively, moreover patients who has > 70% significant fibrosis had a higher T1 mapping compared with patients with lower grades of fibrosis (p<0.001). With studying each cardiac segment separately, surprisingly significantly mean T1 mapping was higher in late gadolinium enhancement segments compared with non-enhanced areas (p<0.001). Roc curve had proven that T1 mapping is an excellent discriminative tool to diagnose enhancement as a There was also a highly statistically significant positive association between GLS and T1 mapping. A notable negative association was detected between strain and T1 mapping across various myocardial segments.
Conclusion: T1 mapping & GLS proved to be effective tools in identifying patients with fibrosis compared with the gold standard method (late gadolinium enhancement).