Hepatic T1-Time Predicts Cardiovascular Risk in All-Comers Referred for Cardiovascular Magnetic Resonance: A Post-Hoc Analysis

Katharina Mascherbauer, Carolina Donà, Matthias Koschutnik, Varius Dannenberg, Christian Nitsche, Franz Duca, Gregor Heitzinger, Kseniya Halavina, Eva Steinacher, Christina Kronberger, Constanze Bardach, Dietrich Beitzke, Christian Loewe, Elisabeth Waldmann, Michael Trauner, Philipp Barkto, Georg Goliasch, Julia Mascherbauer, Christian Hengstenberg, Andreas Kammerlander

Research output: Journal article (peer-reviewed)Journal article

3 Citations (Scopus)


BACKGROUND: Liver damage is frequently observed in patients with cardiovascular disease but infrequently quantified. We hypothesized that in patients with cardiovascular disease undergoing cardiac magnetic resonance, liver T1-times indicate liver damage and are associated with cardiovascular outcome.

METHODS: We measured hepatic T1-times, displayed on standard cardiac T1-maps, in an all-comer cardiac magnetic resonance-cohort. At the time of cardiac magnetic resonance, we assessed validated general liver fibrosis scores. Kaplan-Meier estimates and Cox-regression models were used to investigate the association between hepatic T1-times and a composite endpoint of non-fatal myocardial infarction, heart failure hospitalization, and death.

RESULTS: One thousand seventy-five participants (58±18 year old, 47% female) were included (972 patients, 50 controls, 53 participants with transient elastography). Hepatic T1-times were 590±89 ms in patients and 574±45 ms in controls (P=0.052). They were significantly correlated with cardiac size and function, presence of atrial fibrillation, NT-pro-BNP levels, and gamma-glutamyl-transferase levels (P<0.001 for all). During follow-up (58±31 months), a total of 280 (29%) events occurred. On Cox-regression, high hepatic T1-times yielded a significantly higher risk for events (adjusted hazard ratio, 1.66 [95% CI, 1.45-1.89] per 100 ms increase; P<0.001), even when adjusted for age, sex, left and right ventricular ejection fraction, NT-proBNP (N-terminal prohormone of brain natriuretic peptide), and myocardial T1-time. On receiver operating characteristic analysis and restricted cubic splines, we found that a hepatic T1-time exceeding 610 ms was associated with excessive risk.

CONCLUSIONS: Hepatic T1-times on standard cardiac magnetic resonance scans were significantly associated with cardiac size and function, comorbidities, natriuretic peptides, and independently predicted cardiovascular mortality and morbidity. A hepatic T1-time >610 ms seems to indicate excessive risk.

REGISTRATION: URL: https://www.

CLINICALTRIALS: gov; Unique identifier: NCT04220450.

Original languageEnglish
Pages (from-to)721-732
Number of pages12
JournalCirculation: Cardiovascular Imaging
Issue number10
Publication statusPublished - 01 Oct 2022


  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Cardiovascular Diseases/epidemiology
  • Heart Disease Risk Factors
  • Liver/diagnostic imaging
  • Magnetic Resonance Spectroscopy
  • Time Factors
  • heart failure
  • magnetic resonance imaging
  • liver

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology, Nuclear Medicine and Imaging


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