Primary research question:
Is higher myocardial T2 value on cardiac MRI associated with an increased risk of incident heart failure in individuals without known cardiovascular disease?
Secondary research questions:
Is myocardial T2 associated with subclinical left ventricular dysfunction (LV mass, volumes, ejection fraction)?
Does myocardial T2 provide prognostic information beyond conventional cardiovascular risk factors and standard CMR metrics?
Aims:
To quantify the association between myocardial T2 mapping values and future heart failure events in the UK Biobank imaging cohort.
Background and scientific rationale
Myocardial T2 mapping is a quantitative cardiac MRI technique sensitive to myocardial water content and inflammation. Elevated T2 values are well described in acute inflammatory conditions such as myocarditis; however, the significance of modest T2 elevation in asymptomatic individuals remains unclear.
Subclinical myocardial inflammation or oedema may represent an early pathophysiological process preceding structural remodeling and the development of heart failure. Large population studies evaluating this hypothesis are lacking due to limited availability of T2 mapping data.
UK Biobank provides a unique opportunity to investigate myocardial T2 mapping in a large, well-characterised population with long-term outcome follow-up. Understanding whether myocardial T2 predicts incident heart failure beyond standard risk factors and imaging measures could improve early risk stratification and inform future preventative strategies.
This study focuses on a single, clinically relevant outcome (incident heart failure) to ensure feasibility, interpretability, and public health relevance.