Rapid Fire Session

Session: Rapid Fire Session 2: Diffusion Imaging and Cardiomyopathy (Monitor 4)

Sex and age specific normal values for cardiac diffusion tensor imaging metrics

Thursday, February 5, 2026

3:45 PM - 3:52 PM

Location: Galapagos / Aruba / Ilhabela (2nd Lower Level)

Presenting Author(s)

ML

May Lwin, MD

Clinical Research Fellow
University of Leeds
Leeds, England, United Kingdom

Primary Author(s)

MA

Mehak Asad, MD, MPH

Clinical research fellow
University of Leeds, Multidisciplinary Cardiovascular Research Centre and Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, LS2 9JT, United Kingdom
Leeds, England, United Kingdom

Co-Author(s)

lb

lisa borg, MB

Cardiology Consultant
Leeds Institute of Cardiovascular and Metabolic Medicine, United Kingdom
IT

Irvin Teh, PhD

Senior Research Fellow
Leeds Institute of Cardiovascular and Metabolic Medicine
Leeds, England, United Kingdom
CS

Chin Soo, MB

CRF
LICAMM
Leeds, England, United Kingdom
TA

Thomas Anderton, MB

CRF
LICAMM
Leeds, England, United Kingdom
Bradley Chambers

Clinical Research Fellow
University of Leeds
Harewood, England, United Kingdom
Maryum Farooq, MB

Research Fellow
Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds
Leeds, England, United Kingdom
Sven Plein, MD, PhD

Professor of Cardiology
Leeds Institute of Cardiovascular and Metabolic Medicine
Leeds, England, United Kingdom
Jurgen E. Schneider, PhD

Professor of Biomedical Imaging
Leeds Institute of Cardiovascular and Metabolic Medicine
Leeds, England, United Kingdom
ED

Erica Dall'Armellina, PhD

Associate Professor and Honorary Consultant Cardiologist
University of Leeds, England, United Kingdom

Background: Cardiac diffusion tensor imaging (cDTI) is a novel non-invasive method that allows assessment of myocardial microstructure. Previous studies have shown cDTI parameter changes in cardiac disease such as HCM, dilated cardiomyopathy and MI compared to small cohorts of normal controls (1–4). As the method matures, it is important to establish baseline “normal” key parameters in healthy volunteers and their changes due to biometric measures in healthy populations to improve reliability and statistical power, and generalize findings to larger populations. We aim to establish healthy baseline metrics for motion compensated spin echo (MCSE) cDTI data according to sex and age.

Methods: Seventy-four healthy subjects underwent CMR on a 3T Prisma Siemens scanner. Cine images and cDTI were acquired using a free breathing second-order MCSE sequence, acquisition parameters were: TE/TR 77ms/3 RR intervals, FOV 320x121 mm2, matrix size 138x52, in-plane resolution 2.3 mm x 2.3 mm, 8 mm slice thickness, 8 mm inter-slice gap, partial Fourier= 7/8 with b-values of 100 s/mm² (3 DW directions, 12 repetitions), and 450 s/mm² (30 DW directions, 6 repetitions). Post-processing was performed on a software developed in house. Three slices; basal, mid and apical were included and all frames were analysed visually and those corrupted by motion artefact were removed. Data were compared for young ( < 40 years; n=25) and older ( >40 years; n=49) and male (39) and female (35) patients using the Shapiro-Wilks test for normality and the independent Students t-test.

Results: CMR image acquisition and cDTI analysis was successful in all included study subjects. CMR parameters and demographics were significantly different between male and female participants, except for LVEF but were similar across age groups (Table 1). While MD and E2A were similar, FA was significantly different between males and females (p=0.017) (Table 2). All cDTI parameters differed significantly between the two age groups (Table 2) with an increase in MD and E2A and a decrease in FA in older subjects.

Conclusion: This is the largest investigation of MCSE cDTI metrics in a healthy population as assessed by age or gender. Our results show differences of all metrics across age groups with some differences according to sex. The difference in global FA may represent greater cardiomyocyte disorganization or collagen deposition in the male population compared to the female population. Our results imply that as the heart ages, there is a change in microstructure as detected by an increase in MD, an alteration in sheetlet orientation (E2A), and a decrease in FA; such changes could be linked to changes in extracellular space, collagen deposition, changes in cellular size or an increase in blood supply.

Table 1. CMR parameters and demographics

Variable	< 40 years (n=25)	>40 years(n=49)	Female (n=35)	Male (n=39)	< 40 vs >40p-value	Female vs Malep-value
Age (yrs)	29 (6)	62 (11)	45 (18)	56 (16)	< 0.001	0.006
Height (cm)	170 (10)	172 (10)	165 (8)	176 (9)	0.491	< 0. 001
Weight (kg)	72 (14)	76 (13)	68 (12)	80 (12)	0.228	< 0.001
BSA (m²)	1.8 (0.2)	1.9 (0.2)	1.8 (0.2)	2.0 (0.2)	0.211	< 0.001
LVEDVi (mL/m²)	85 (15)	82 (15)	79 (12)	87 (16)	0.454	0.015
LVEF (%)	60 (4)	61 (5)	61 (4)	61 (4)	0.355	0.973
LVM (g)	94 (31)	100 (28)	80 (20)	114 (27)	0.199	< 0.001

BSA, body surface area; LVEDVi, left ventricular end diastolic volume indexed; LVEF, left ventricular ejection fraction; LVM, left ventricular mass

Values shown are mean with SD in brackets.Table 2. Global cDTI metrics according to gender and age

Variable	< 40 years (n=25)	>40 years (n=49)	Female (n=35)	Male (n=39)	< 40 vs >40p-value	Female vs Malep-value
Global MD (x 10-3 mm2/s)	1.46 (0.05)	1.48 (0.04)	1.47 (0.05)	1.48. (0.05)	0.010	0.237
Global FA	0.35 (0.02)	0.32 (0.02)	0.34 (0.03)	0.33 (0.02)	< 0.001	0.017
Global \|E2A\|°	37 (10.8)	44.3 (8)	40 (11.1)	43.5 (8)	< 0.001	0.115

MD, mean diffusivity; FA, fractional anisotropy; E2A, secondary eigenvector angle

Values shown are mean with SD in brackets.