Native myocardial T1 and ECV with age and gender developing normal reference ranges - a 94 healthy volunteer study

Background Measurement of native T1 and extracellular volume fraction (ECV) allow quantification of diffuse myocardial fibrosis. Normal references ranges are not definitively established. The concept of increasing fibrosis with age is widely held, despite a lack of supportive evidence from tissue studies some of which say the opposite (Olivetti 1991) or point to other age changes eg myocardial lipofuschin or haemosiderin accumulation. Whether the ECV increases with age is unclear The MESA study found a small ECV increase with age (R 0.021, p = 0.012, Lima JACC 2013) but used measurement rather than mapping, whilst others (Ugander, Schelbert) found increases but with small populations or with significant comorbidities. Using state-of-the-art mapping, we sought to determine whether T1 and ECV increase with age both to understand the aging biology and as a step towards developing normal reference ranges.