Myocardial Native T1 Mapping in the German National Cohort (NAKO): Associations with Age, Sex, and Cardiometabolic Risk Factors

作者：Clemens Ammann, Jan Gröschel, Hadil Saad, Susanne Rospleszcz, Christopher Schuppert, Thomas Hadler, Richard Hickstein, Thoralf Niendorf, Janis M. Nolde, Matthias B. Schulze, Karin Halina Greiser, Hermann Brenner, Ute Mons, Josua A. Decker, Thomas Kröncke, Thomas Küstner, Konstantin Nikolaou, Stefan N. Willich, Thomas Keil, Marcus Dörr, Robin Bülow, Fabian Bamberg, Tobias Pischon, Christopher L. Schlett, Jeanette Schulz‐Menger · 发表于：Journal of Cardiovascular Magnetic Resonance · 年份：2026 · DOI：10.1016/j.jocmr.2026.102781 · 研究领域：Cardiac Imaging and Diagnostics、Cardiovascular Function and Risk Factors、Acute Myocardial Infarction Research

Abstract Background In cardiovascular magnetic resonance (CMR), myocardial native T1 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 T1 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 T1 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 T1 were evaluated using multiple linear regression models adjusted for age, sex, heart rate, imaging site, and comorbidities. Results After quality control, 27,794 participants (44.6% women; 20–75 years) were included. Mean T1 was higher in women (1,231 ± 33 ms) than in men (1,209 ± 34 ms), with sex differences progressively declining with age. In adjusted ana...