{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T05:46:50Z","timestamp":1782539210318,"version":"3.54.5"},"reference-count":53,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Risk stratification in non-ischemic dilated cardiomyopathy (DCM) remains challenging because left ventricular ejection fraction (LVEF) and late gadolinium enhancement (LGE) do not fully capture the underlying myocardial substrate. Septal native T1 mapping provides a quantitative assessment of diffuse myocardial abnormalities and may contribute to myocardial tissue characterization within a multiparametric CMR framework. Methods: This retrospective single-center study included 45 consecutive patients with non-ischemic DCM referred for clinically indicated CMR at Perrino Hospital, Brindisi, Italy, between November 2023 and November 2025. All examinations were performed using a standardized CMR protocol including cine imaging, LGE, and native T1 mapping on a 1.5-T Siemens Healthineers scanner. Septal native T1 was used as the primary mapping parameter because of its established reproducibility and robustness for myocardial tissue characterization. Patients were followed for a composite endpoint including all-cause mortality, major ventricular arrhythmic events, appropriate ICD therapy, and hospitalization for heart failure. Endpoint coding was verified, and all analyses were performed using the final validated dataset. Results: During a median follow-up of 15 months, 14 patients (31.1%) experienced the composite endpoint. Patients with events had lower LVEF (27.1 \u00b1 7.8% vs. 48.3 \u00b1 10.5%; p &lt; 0.001), higher LVEDVi (142.6 \u00b1 28.5 vs. 110.6 \u00b1 23.4 mL\/m2; p = 0.001), and higher septal native T1 values among patients with available T1 measurements (1047.5 \u00b1 25.0 vs. 1031.5 \u00b1 24.3 ms; p = 0.065). ROC analysis identified a septal native T1 threshold of 1042 ms for prediction of the composite endpoint, with an exploratory AUC of 0.70. Event-free survival was lower in patients with septal native T1 \u2265 1042 ms. Given the limited number of events, all regression and hierarchical analyses should be interpreted as exploratory and hypothesis-generating. Conclusions: Higher septal native T1 values were observed in patients experiencing adverse clinical outcomes; however, native T1 was not independently associated with the composite endpoint in exploratory Cox regression analyses.<\/jats:p>","DOI":"10.3390\/jcdd13060279","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:37:42Z","timestamp":1781879862000},"page":"279","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Native T1 Mapping and Clinical Risk Characterization in Non-Ischemic Dilated Cardiomyopathy: A Cardiac Magnetic Resonance Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1526-5047","authenticated-orcid":false,"given":"Manuela","family":"Montatore","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Medicine, School of Medicine, University of Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3747-2805","authenticated-orcid":false,"given":"Marco","family":"Rella","sequence":"additional","affiliation":[{"name":"Radiology Unit, \u201cA. Perrino\u201d Hospital, ASL Brindisi, 72100 Brindisi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7221-9907","authenticated-orcid":false,"given":"Eleonora","family":"Indolfi","sequence":"additional","affiliation":[{"name":"Cardiology Unit, \u201cD. Camberlingo\u201d Hospital, ASL Brindisi, 72021 Francavilla Fontana, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4289-3289","authenticated-orcid":false,"given":"Federica","family":"Masino","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, School of Medicine, University of Foggia, 71122 Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruggiero","family":"Tupputi","sequence":"additional","affiliation":[{"name":"Radiology Unit, \u201cDimiccoli\u201d Hospital, Viale Ippocrate 15, 70051 Barletta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9807-3326","authenticated-orcid":false,"given":"Eluisa","family":"Muscogiuri","sequence":"additional","affiliation":[{"name":"Radiology Unit, \u201cA. Perrino\u201d Hospital, ASL Brindisi, 72100 Brindisi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4325-8330","authenticated-orcid":false,"given":"Giuseppe","family":"Guglielmi","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, School of Medicine, University of Foggia, 71122 Foggia, Italy"},{"name":"Radiology Unit, \u201cDimiccoli\u201d Hospital, Viale Ippocrate 15, 70051 Barletta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/S0140-6736(16)31713-5","article-title":"Dilated cardiomyopathy","volume":"390","author":"Weintraub","year":"2017","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.1093\/eurheartj\/ehv727","article-title":"Proposal for a revised definition of dilated cardiomyopathy, hypokinetic non-dilated cardiomyopathy, and its implications for clinical practice","volume":"37","author":"Pinto","year":"2016","journal-title":"Eur. 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