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Rapid Fire Abstracts

Rapid Fire 09- CMR Analysis (including machine learning) III

Fingerprinting Sex Specific Differences in Cardiac Function, Structure, and Morphology: A Cardiac MRF Study (RF_SA_437)

Saturday, February 1, 2025
9:50 AM – 10:00 AM East Coast USA Time
Location: Blue Room PreFunction - Kiosk 1
Background: Recent studies have elucidated important sex-differences in cardiac function, structure and morphology at macrostructural, cellular, and protein signaling levels.1-4 Sex differences in left ventricular (LV) function,  global longitudinal strain (GLS), and LV size have previously been identified.5 Cardiac Magnetic Resonance Fingerprinting (cMRF) simultaneously acquires tissue T1/T2 times with increased precision and reproducibility, which may enable identification of sex as a biologic determinant of cardiac structure, function, and morphology.3  Therefore, we sought to compare the correlation of sex differences in LV mechanics with conventional vs cMRF T1/T2 mapping in healthy volunteers. This study aims to (1) evaluate sex differences in healthy volunteers with parametric mapping and (2) compare strength of the correlation between cMRF vs conventional T1/T2 mapping with LV strain.

Methods: Healthy volunteers (15 males, 24 females) were scanned on a Siemens CIMA 3T scanner using cMRF, Modified Look Locker (MOLLI) T1, and T2-prepared FLASH T2 mapping. The cMRF acquisition was a prospectively ECG-gated (or peripheral pulse-gated), breath-held scan at end-diastole with a voxel size of 1.6x1.6x8 mm3, spiral readout, 254 ms temporal duration, and acquired over 15 heartbeats for three cardiac short axis slices. MOLLI T1 and T2-prepared FLASH T2 maps were generated with the vendor’s inline reconstruction. The cMRF data were reconstructed using voxel-wise inner product matching to scan-specific dictionaries that included slice profile and preparation pulse efficiency corrections. Cine images were processed using CVI42 software to obtain segmental measurements of longitudinal, radial, and circumferential strain (Fig. 1). T1 and T2 values from cMRF and conventional methods were correlated with strain measurements using Spearman’s correlation analysis.

Results: LV parameters, including T1/T2 mapping (conventional vs cMRF) in men vs women are shown in Table 1. Females demonstrated significantly higher T1 time, compared to men, with both conventional and MRF acquisition (1241 vs 1211 ms, p=0.0027), (1427 vs 1395 ms, p=0.0071), respectively. While this study was underpowered to discern sex differences in LV strain indices, MRF T1 mapping showed significant correlation with LV GLS.  Fig. 2 illustrates significant correlation in males (rho= 0.6848, p=0.0351) and females (rho= -0.5404, p=0.0206). Conventional T1 mapping did not correlation with LV GLS.

Conclusion: MOLLI and cMRF both identify significant increase in T1 times in healthy females compared to males. cMRF T1 mapping resulted in significantly stronger correlation with LV GLS compared to MOLLI T1 mapping. Larger healthy volunteer studies are required to validate sex differences in the directionality of correlation. cMRF may provide unique ability to identify sex differences in underlying myocardial substrate and subsequent related impact on function in both health and disease.