ArticleEuropean radiology2024
A novel cardiac magnetic resonance-based personalized risk stratification model in dilated cardiomyopathy: a prospective study.
Article in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Cardiovascular magnetic resonance-based arrhythmogenic substrate assessment improves sudden cardiac death risk stratification in heart failure with mildly reduced ejection fraction: a multicenter retrospective observational study.The Lancet regional health. Western Pacific · 2026Article
- Quantification of coronary artery calcium using virtual non-contrast images derived from dual-layer spectral CT.La Radiologia medica · 2026Article
- Redefining Sudden Cardiac Death Risk Stratification in Dilated Cardiomyopathy: An Integrative Approach.Reviews in cardiovascular medicine · 2026Review
- Reduced right/left ventricular blood pool T2 ratio on cardiac magnetic resonance indicates cognitive impairment in heart failure secondary to ischemic heart disease.BMC medical imaging · 2026Article
- CMR-LGE imaging features of dilated cardiomyopathy and relationship with left ventricular function.Scientific reports · 2025Article
- Prognostic implications of biventricular strain and ischemic-pattern fibrosis in non-ischemic dilated cardiomyopathy with type 2 diabetes mellitus: a cardiac MRI cohort study.Quantitative imaging in medicine and surgery · 2025Article
- Risk Stratification of Sudden Cardiac Death in Nonischemic Dilated Cardiomyopathy: Arrhythmogenic Substrate Assessment in Cardiac MRI.Radiology · 2025Observational
- Letter to the Editor: "Accurate measurement of magnetic resonance parkinsonism index by a fully automatic and deep learning quantification pipeline".European radiology · 2023Article
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Authors and funding
16 authors.
Funding
Abstract
objectivesTo explore individual weight of cardiac magnetic resonance (CMR) metrics to predict mid-term outcomes in patients with dilated cardiomyopathy (DCM), and develop a risk algorithm for mid-term outcome based on CMR biomarkers. MATERIALS AND
methodsPatients with DCM who underwent CMR imaging were prospectively enrolled in this study. The primary endpoint was a composite of heart failure (HF) death, sudden cardiac death (SCD), aborted SCD, and heart transplantation.
resultsA total of 407 patients (age 48.1 ± 13.8 years, 331 men) were included in the final analysis. During a median follow-up of 21.7 months, 63 patients reached the primary endpoint. NYHA class III/IV (HR = 2.347 [1.073-5.133], p = 0.033), left ventricular ejection fraction (HR = 0.940 [0.909-0.973], p < 0.001), late gadolinium enhancement (LGE) > 0.9% and ≤ 6.6% (HR = 3.559 [1.020-12.412], p = 0.046), LGE > 6.6% (HR = 6.028 [1.814-20.038], p = 0.003), and mean extracellular volume (ECV) fraction ≥ 32.8% (HR = 5.922 [2.566-13.665], p < 0.001) had a significant prognostic association with the primary endpoints (C-statistic: 0.853 [0.810-0.896]). Competing risk regression analyses showed that patients with mean ECV fraction ≥ 32.8%, LGE ≥ 5.9%, global circumferential strain ≥ - 5.6%, or global longitudinal strain ≥ - 7.3% had significantly shorter event-free survival due to HF death and heart transplantation. Patients with mean ECV fraction ≥ 32.8% and LGE ≥ 5.9% had significantly shorter event-free survival due to SCD or aborted SCD.
conclusionECV fraction may be the best independently risk factor for the mid-term outcomes in patients with DCM, surpassing LVEF and LGE. LGE has a better prognostic value than other CMR metrics for SCD and aborted SCD. The risk stratification model we developed may be a promising non-invasive tool for decision-making and prognosis. CLINICAL RELEVANCE STATEMENT: "One-stop" assessment of cardiac function and myocardial characterization using cardiac magnetic resonance might improve risk stratification of patients with DCM. In this prospective study, we propose a novel risk algorithm in DCM including NYHA functional class, LVEF, LGE, and ECV. KEY POINTS: • The present study explores individual weight of CMR metrics for predicting mid-term outcomes in dilated cardiomyopathy. • We have developed a novel risk algorithm for dilated cardiomyopathy that includes cardiac functional class, ejection fraction, late gadolinium enhancement, and extracellular volume fraction. • Personalized risk model derived by CMR contributes to clinical assessment and individual decision-making.
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