ArticleJACC. Cardiovascular imaging2021
Progression of Myocardial Fibrosis in Nonischemic DCM and Association With Mortality and Heart Failure Outcomes.
Article in JACC. Cardiovascular imaging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.
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Who cites it
52 citing papers in PubMed, 2 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Pooled it
- Impact of late gadolinium-enhanced cardiac MRI on arrhythmic and mortality outcomes in nonischemic dilated cardiomyopathy: updated systematic review and meta-analysis.Scientific reports · 2023Pooled it
- Mechanical stretch reduces fibroblast activation in heart failure with reduced ejection fraction.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2026Article
- Senescence dynamics define therapeutic windows for Duchenne muscular dystrophy in DBA/2-mdx mice.Skeletal muscle · 2026Article
- Association Between Different Vericiguat Dose Exposures, Concomitant Quadruple Heart Failure Therapy, and Myocardial Fibrosis Burden in Older Adults with Worsening Heart Failure with Reduced Ejection Fraction.Anatolian journal of cardiology · 2026Article
- Prevalence and prognosis of non-dilated left ventricular cardiomyopathy in patients referred for cardiac magnetic resonance.European radiology · 2026Article
- Article
- Single cell transcriptomic landscape of adult and pediatric non-ischemic cardiomyopathy.Journal of molecular and cellular cardiology · 2026Review
- Pathological classification of non-ischaemic dilated cardiomyopathy based on deep learning.European heart journal. Digital health · 2026Article
- Mitochondrial dysfunction in diabetic cardiomyopathy: a review of pathogenic mechanisms and therapeutic strategies.Frontiers in cardiovascular medicine · 2026Review
- Nanomedicine-Based Strategies for Mitigating Chemo/Radiotherapy-Induced Cardiac Inflammation and Fibrosis.Cardiovascular toxicology · 2025Review
- Safety and prognostic value of left ventricular endomyocardial biopsy in dilated cardiomyopathy.European journal of heart failure · 2025Article
- Preventing hypocontractility-induced fibroblast expansion alleviates dilated cardiomyopathy.Science (New York, N.Y.) · 2025Article
- Cardiac fibrosis: from mechanisms and models to medicines.Trends in pharmacological sciences · 2025Review
- Efficacy of Bone Marrow-Derived Stem Cells on Non-Ischemic Cardiomyopathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of clinical medicine · 2025Review
- Integrative Transcriptomic-Histological Analysis in Dilated Cardiomyopathy Unveils FGFR1 Inhibition as Anti-Cardiac Fibrotic and Cardioprotective Therapy.JACC. Basic to translational science · 2025Article
- Septin4 Regulates Cardiac Fibrosis After Pressure Overload.Circulation research · 2025Article
- CMR-FT right atrial strain is a novel predictive indicator in left ventricular noncompaction patients: a multi-center study.Journal of translational medicine · 2025Article
- Prognostic impact of angiography-derived index of microcirculatory resistance in patients with dilated cardiomyopathy.International journal of cardiology. Cardiovascular risk and prevention · 2025Article
- Left Ventricular Ring-like Pattern: The Arrhythmic Tale of a Scarred Heart.Journal of cardiovascular development and disease · 2025Review
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Authors and funding
11 authors at 7 institutions in 2 countries.
Funding
Abstract
objectivesThe purpose of this study was to assess whether the presence and extent of fibrosis changes over time in patients with nonischemic, dilated cardiomyopathy (DCM) receiving optimal medical therapy and the implications of any such changes on left ventricular ejection fraction (LVEF) and clinical outcomes.
backgroundMyocardial fibrosis on cardiovascular magnetic resonance (CMR) imaging has emerged as important risk marker in patients with DCM.
methodsIn total, 85 patients (age 56 ± 15 years, 45% women) with DCM underwent serial CMR (median interval 1.5 years) for assessment of LVEF and fibrosis. The primary outcome was all-cause mortality; the secondary outcome was a composite of heart failure hospitalization, aborted sudden cardiac death, left ventricular (LV) assist device implantation, or heart transplant.
resultsOn CMR-1, fibrosis (median 0.0 [interquartile range: 0% to 2.6%]) of LV mass was noted in 34 (40%) patients. On CMR-2, regression of fibrosis was not seen in any patient. Fibrosis findings were stable in 70 (82%) patients. Fibrosis progression (increase >1.8% of LV mass or new fibrosis) was seen in 15 patients (18%); 46% of these patients had no fibrosis on CMR-1. Although fibrosis progression was on aggregate associated with adverse LV remodeling and decreasing LVEF (40 ± 7% to 34 ± 10%; p < 0.01), in 60% of these cases the change in LVEF was minimal (<5%). Fibrosis progression was associated with increased hazards for all-cause mortality (hazard ratio: 3.4 [95% confidence interval: 1.5 to 7.9]; p < 0.01) and heart failure-related complications (hazard ratio: 3.5 [95% confidence interval: 1.5 to 8.1]; p < 0.01) after adjustment for clinical covariates including LVEF.
conclusionsOnce myocardial replacement fibrosis in DCM is present on CMR, it does not regress in size or resolve over time. Progressive fibrosis is often associated with minimal change in LVEF and identifies a high-risk cohort.
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