April 20, 2026Journal of the American College of Cardiology
Cardiovascular Magnetic Resonance, Fibrosis, and Prognosis in Dilated Cardiomyopathy
Key result
CMR-detected midwall fibrosis in DCM is linked to ~240% higher risk of death and CV hospitalization.
- HR 3.4
- P=0.01
- n=101
Why the study?
Does the presence of midwall fibrosis detected by CMR predict all-cause death and cardiovascular hospitalization in patients with dilated cardiomyopathy?
Population
101 consecutive patients with dilated cardiomyopathy (DCM)
Comparison
Presence of midwall fibrosis detected by late… vs Absence of midwall fibrosis
Design
Cohort
Follow-up
658 +/- 355 days
Authors
Discussion
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Implication
Supports CMR risk stratification in DCM but should not change practice; leaves open role in ICD decisions pending RCTs.
Key Points
- This research aims to examine the impact of midwall fibrosis on prognosis in patients with dilated cardiomyopathy.
- Prospective longitudinal study involving 101 consecutive patients with dilated cardiomyopathy.
- Patients were followed for an average of 658 days to assess cardiovascular events.
- Midwall fibrosis was evaluated using late gadolinium-enhancement cardiovascular magnetic resonance.
- Midwall fibrosis was found in 35% of patients and was associated with a higher event rate (HR 3.4, p = 0.01) for all-cause death and hospitalization.
- It was identified as the only significant predictor of death or hospitalization in multivariate analysis.
- Midwall fibrosis predicted sudden cardiac death or ventricular tachycardia (HR 5.2, p = 0.03).
Study Design
Type
Cohort (n=101)
Structured PICO
Does the presence of midwall fibrosis detected by CMR predict all-cause death and cardiovascular hospitalization in patients with dilated cardiomyopathy?
P
Population
101 consecutive patients with dilated cardiomyopathy (DCM)
I
Intervention
Presence of midwall fibrosis detected by late gadolinium-enhancement (LGE) cardiovascular magnetic resonance (CMR)
C
Comparator
Absence of midwall fibrosis
O
Outcome
Combined end point of all-cause death and hospitalization for a cardiovascular eventcomposite
Main Result
Effect estimate: HR 3.4
p-value: p=0.01
Midwall fibrosis detected by CMR is a strong independent predictor of mortality, cardiovascular hospitalization, and sudden cardiac death or ventricular tachycardia in patients with dilated cardiomyopathy.
Cite This Study
Assomull et al. (2006) conducted a cohort in Dilated cardiomyopathy (DCM) (n=101). Midwall fibrosis detected by CMR vs. Absence of midwall fibrosis was evaluated on Combined end point of all-cause death and hospitalization for a cardiovascular event (HR 3.4, p=0.01). Midwall fibrosis detected by CMR in dilated cardiomyopathy was associated with a higher rate of all-cause death and cardiovascular hospitalization (HR 3.4, p=0.01).