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

doi:10.1161/CIRCIMAGING.122.014716

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

Division of Internal Medicine 3 (University Hospital St. Pölten)

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

10 Citations (Scopus)

Abstract

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 language	English
Pages (from-to)	721-732
Number of pages	12
Journal	Circulation: Cardiovascular Imaging
Volume	15
Issue number	10
DOIs	https://doi.org/10.1161/CIRCIMAGING.122.014716
Publication status	Published - 01 Oct 2022

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

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

Access to Document

10.1161/CIRCIMAGING.122.014716

Cite this

Mascherbauer, K., Donà, C., Koschutnik, M., Dannenberg, V., Nitsche, C., Duca, F., Heitzinger, G., Halavina, K., Steinacher, E., Kronberger, C., Bardach, C., Beitzke, D., Loewe, C., Waldmann, E., Trauner, M., Barkto, P., Goliasch, G., Mascherbauer, J., Hengstenberg, C., & Kammerlander, A. (2022). Hepatic T1-Time Predicts Cardiovascular Risk in All-Comers Referred for Cardiovascular Magnetic Resonance: A Post-Hoc Analysis. Circulation: Cardiovascular Imaging, 15(10), 721-732. https://doi.org/10.1161/CIRCIMAGING.122.014716

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

abstract = "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.",

keywords = "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",

author = "Katharina Mascherbauer and Carolina Don{\`a} and Matthias Koschutnik and Varius Dannenberg and Christian Nitsche and Franz Duca and Gregor Heitzinger and Kseniya Halavina and Eva Steinacher and Christina Kronberger and Constanze Bardach and Dietrich Beitzke and Christian Loewe and Elisabeth Waldmann and Michael Trauner and Philipp Barkto and Georg Goliasch and Julia Mascherbauer and Christian Hengstenberg and Andreas Kammerlander",

year = "2022",

month = oct,

day = "1",

doi = "10.1161/CIRCIMAGING.122.014716",

language = "English",

volume = "15",

pages = "721--732",

journal = "Circulation: Cardiovascular Imaging",

issn = "1941-9651",

publisher = "Lippincott Williams and Wilkins",

number = "10",

}

Mascherbauer, K, Donà, C, Koschutnik, M, Dannenberg, V, Nitsche, C, Duca, F, Heitzinger, G, Halavina, K, Steinacher, E, Kronberger, C, Bardach, C, Beitzke, D, Loewe, C, Waldmann, E, Trauner, M, Barkto, P, Goliasch, G, Mascherbauer, J, Hengstenberg, C & Kammerlander, A 2022, 'Hepatic T1-Time Predicts Cardiovascular Risk in All-Comers Referred for Cardiovascular Magnetic Resonance: A Post-Hoc Analysis', Circulation: Cardiovascular Imaging, vol. 15, no. 10, pp. 721-732. https://doi.org/10.1161/CIRCIMAGING.122.014716

TY - JOUR

T1 - Hepatic T1-Time Predicts Cardiovascular Risk in All-Comers Referred for Cardiovascular Magnetic Resonance

T2 - A Post-Hoc Analysis

AU - Mascherbauer, Katharina

AU - Donà, Carolina

AU - Koschutnik, Matthias

AU - Dannenberg, Varius

AU - Nitsche, Christian

AU - Duca, Franz

AU - Heitzinger, Gregor

AU - Halavina, Kseniya

AU - Steinacher, Eva

AU - Kronberger, Christina

AU - Bardach, Constanze

AU - Beitzke, Dietrich

AU - Loewe, Christian

AU - Waldmann, Elisabeth

AU - Trauner, Michael

AU - Barkto, Philipp

AU - Goliasch, Georg

AU - Mascherbauer, Julia

AU - Hengstenberg, Christian

AU - Kammerlander, Andreas

PY - 2022/10/1

Y1 - 2022/10/1

N2 - 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.

AB - 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.

KW - Adult

KW - Aged

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Cardiovascular Diseases/epidemiology

KW - Heart Disease Risk Factors

KW - Liver/diagnostic imaging

KW - Magnetic Resonance Spectroscopy

KW - Time Factors

KW - heart failure

KW - magnetic resonance imaging

KW - liver

UR - https://www.scopus.com/pages/publications/85140153787

U2 - 10.1161/CIRCIMAGING.122.014716

DO - 10.1161/CIRCIMAGING.122.014716

M3 - Journal article

C2 - 36256728

SN - 1941-9651

VL - 15

SP - 721

EP - 732

JO - Circulation: Cardiovascular Imaging

JF - Circulation: Cardiovascular Imaging

IS - 10

ER -

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

Abstract

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Keywords

ASJC Scopus subject areas

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