What does this research mean for the field?

CMR-modelled PCWP ≥ 15 mmHg is associated with a 2.11-fold increased risk of adverse outcomes compared to PCWP < 15 mmHg in patients with non-ischemic cardiomyopathy. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To evaluate how cardiac magnetic resonance (CMR) modeled pulmonary capillary wedge pressure (PCWP) predicts adverse outcomes in patients with non-ischemic cardiomyopathy.

January 10, 2026

Assessment of Left Ventricular Filling Pressure by Cardiac Magnetic Resonance Imaging as a Predictor of Adverse Outcomes in Patients with Non-ischemic Cardiomyopathy

Q: What are the key findings of this study?

CMR-modelled PCWP ≥ 15 mmHg was associated with a 2.11-fold increased risk of adverse outcomes compared to PCWP < 15 mmHg in patients with NICM.

Q: What question did this study set out to answer?

To evaluate how cardiac magnetic resonance (CMR) modeled pulmonary capillary wedge pressure (PCWP) predicts adverse outcomes in patients with non-ischemic cardiomyopathy.

Key Result

CMR-modelled PCWP ≥ 15 mmHg was associated with a 2.11-fold increased risk of adverse outcomes compared to PCWP < 15 mmHg in patients with NICM.

Key Points

To evaluate how cardiac magnetic resonance (CMR) modeled pulmonary capillary wedge pressure (PCWP) predicts adverse outcomes in patients with non-ischemic cardiomyopathy.
Retrospective study of non-ischemic cardiomyopathy patients who underwent CMR from 2008 to 2017.
Calculated CMR-modelled PCWP using left atrial volume and left ventricular mass measurements.
Analyzed all-cause mortality, heart transplantation, and hospitalization for heart failure as primary outcomes.
Utilized multivariable Cox proportional hazards models for prognostic assessment.
39% of patients with PCWP ≥ 15 mmHg reached the primary outcome versus 21% with PCWP < 15 mmHg.
The hazard ratio (HR) for adverse outcomes with PCWP ≥ 15 mmHg was 2.11 (95% CI 1.48–3.01; P < 0.001).
Findings indicate independent prognostic value of CMR-modelled PCWP in risk stratification among low-risk classified patients.

Structured PICO

Does elevated CMR-modelled PCWP (≥ 15 mmHg) predict adverse outcomes in patients with non-ischemic cardiomyopathy?

Population

458 patients with non-ischemic cardiomyopathy (NICM) who underwent cardiovascular magnetic resonance (CMR), mean age 53.2 years, mean BMI 29.3 kg/m², mean LVEF 32.8%.

Intervention

CMR-modelled pulmonary capillary wedge pressure (PCWP) ≥ 15 mmHg

Comparator

CMR-modelled pulmonary capillary wedge pressure (PCWP) < 15 mmHg

Outcome

Composite of all-cause mortality, heart transplantation, or hospitalization for heart failure (HHF)composite

CMR-modelled PCWP provides a non-invasive method to independently predict mortality, heart transplantation, and heart failure hospitalization in patients with non-ischemic cardiomyopathy.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background Cardiovascular magnetic resonance (CMR) offers comprehensive assessment of cardiomyopathy but lacks validated methods for estimating left ventricular filling pressure (LVFP), an important prognostic marker. Invasive pulmonary capillary wedge pressure (PCWP) measurements remain a gold standard but are impractical for routine use due to procedural risks. A CMR-modelled PCWP model offers a non-invasive alternative, but its ability to improve prognostic assessment beyond conventional markers has not been well established. We evaluated the prognostic utility of CMR PCWP in patients with non-ischemic cardiomyopathy (NICM). Methods NICM patients who underwent CMR between December 2008 and December 2017 were retrospectively included. CMR-modelled PCWP was calculated as: 6.1352 + (0.07204 × left atrial volume LAV) + (0.02256 × left ventricular mass LVM). The primary outcome was a composite of all-cause mortality, heart transplantation, or hospitalization for heart failure (HHF). Secondary outcomes included HHF and all-cause mortality separately. Multivariable Cox proportional hazards models assessed prognostic value. Results A total of 458 patients (mean age 53.2 years, BMI 29.3 kg/m², LVEF 32.8% ± 11.1%) were followed for a median of 3.6 years. The primary outcome occurred in 39% with PCWP ≥ 15 mmHg versus 21% with PCWP 15 mmHg (HR 2.11, 95% CI 1.48–3.01; P-valute 0.001). Conclusion CMR-modelled PCWP provides independent prognostic value providing further risk differentiation among patients traditionally classified as low-risk.

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