Background/Objectives: The objective of this study was to investigate the association between congestive heart failure (CHF) and T1 mapping in both liver lobes using cardiac MRI. Methods: This retrospective study included patients who underwent cardiac MRI with T1 mapping sequences on a 1.5 T scanner. The liver T1 values were measured in four hepatic regions, utilizing cardiac short axis and four-chamber views. Echocardiographic and laboratory data were collected within 90 days of the cardiac MRI. Comparisons of the liver T1 values and echocardiographic parameters between patients with and without elevated NT-proBNP levels (>125 pg/mL) were conducted using the Mann–Whitney U test. Logistic regression models were employed to adjust for confounding factors. Results: A total of 397 patients were included (with a median age of 56 years; 127 females), of whom 35% (n = 138) exhibited elevated NT-proBNP levels. The patients with elevated NT-proBNP levels showed a larger end-diastolic volume (EDV: 92 vs. 81 mL/m2, p < 0.001) and a lower LVEF level (50% vs. 60%, p < 0.001). The liver T1 was significantly higher in the right liver lobe (670 vs. 596 ms, p < 0.001) and the caudate lobe (664 vs. 598 ms, p < 0.001), but not in the left lobe (571 vs. 568 ms, p = 0.068) or the dome (590 vs. 560 ms, p = 0.1). T1 mapping in the caudate (OR 1.013, 95% CI 1.004–1.023, p = 0.005) and right liver lobes (OR 1.012, 95% CI 1.003–1.021, p = 0.009) remained independently predictive in the logistic regression analysis. Conclusions: Elevated T1 values in the caudate and right liver lobes assessed by cardiac MRI were independently associated with CHF and outperformed T1 measurements in the left liver lobe in predicting disease.
