Elevated native T1 mapping values (>1018 ms) and ECV (>28%) significantly increased the risk of composite cardiovascular events in NICM patients (HRs 6.285 and 19.752, respectively).
Does cardiac magnetic resonance (CMR) imaging assessment predict sudden cardiac death, major ventricular arrhythmic events, and heart failure hospitalization in patients with non-ischemic cardiomyopathy and reduced LVEF?
Elevated native T1 mapping and extracellular volume (ECV) on CMR strongly predict adverse cardiovascular events in patients with non-ischemic cardiomyopathy.
Absolute Event Rate: 0% vs 0%
Cardiac magnetic resonance (CMR) imaging has been considered crucial in non-ischemic cardiomyopathy (NICM). This study aims to evaluate the role of CMR in identifying risk factors for life-threatening events in patients with NICM and reduced left ventricular ejection fraction (LVEF). Methods: We analysed 57 (mean age 62.5 ± 11.4 years, 68.4% male) first-diagnosed NICM patients with reduced LVEF (mean 42 ± 9%). CMR assessments evaluated LVEF, right ventricular ejection fraction (RVEF), cardiac T1 mapping, extracellular volume (ECV), and the presence/extension of late gadolinium enhancement (LGE). Patients were monitored for a composite endpoint including sudden cardiac death (SCD), major ventricular arrhythmic events, and hospitalization for heart failure (HHF). Results During a median follow-up lasting 543 days, 18 patients (31%) experienced cardiovascular events. A higher native T1 mapping value (1076 (1025–1120) ms vs. 999 (990–1037) ms, p < 0.001), a higher ECV (34 ± 6% vs. 28 ± 4,% p < 0.001) and a reduced RVEF (52 ± 13% vs. 60 ± 9%, p < 0.03) proved to be significantly correlated to an increased HHF, arrhythmic and SCD risk. Additionally, a native T1 mapping value exceeding 1018 ms demonstrated an increased risk (HR: 6.285; 95% CI: 2.044–19.326, p = 0.001) as well as an ECV greater than 28% (HR: 19.752; 95% CI: 2.622–148.817, p = 0.004) for composite endpoint. Conclusion In NICM patients, elevated native T1 mapping and ECV values identified a high-risk subgroup for arrhythmic events while LVEF, and RVEF provide further risk stratification for the composite endpoint. CMR assessment may optimize risk stratification in NICM patients.
Pastorini et al. (Tue,) reported a other. Elevated native T1 mapping values (>1018 ms) and ECV (>28%) significantly increased the risk of composite cardiovascular events in NICM patients (HRs 6.285 and 19.752, respectively).