Key result
Worse global circumferential strain and increased LGE predict malignant VAs in NIDCM.
Why the study?
Identifying patients with nonischemic dilated cardiomyopathy at risk of malignant ventricular arrhythmias is challenging in clinical practice.
Do cardiovascular magnetic resonance feature tracking (CMR-FT) parameters predict malignant ventricular arrhythmias in patients with nonischemic dilated cardiomyopathy?
Observational (n=263)
Do cardiovascular magnetic resonance feature tracking (CMR-FT) parameters predict malignant ventricular arrhythmias in patients with nonischemic dilated cardiomyopathy?
p-value: p=<0.001
CMR global strain parameters, particularly GPCS, and percent LGE are independent predictors of malignant ventricular arrhythmias in patients with nonischemic dilated cardiomyopathy, offering prognostic value even in the absence of LGE.
Background: Patients with nonischemic dilated cardiomyopathy (NIDCM) are prone to arrhythmias, and the cause of mortality in these patients is either end-organ dysfunction due to pump failure or malignant arrhythmia-related death. However, identification of patients with NIDCM at risk of malignant ventricular arrhythmias (VAs) is challenging in clinical practice. The aim of this study was to evaluate whether Cardiovascular magnetic resonance feature tracking (CMR-FT) may help in identification of patients with NIDCM at risk of malignant VAs. Methods: 263 NIDCM patients who underwent both CMR, 24-hour Holter electrocardiography (ECG) and inpatient ECG were retrospectively evaluated. The patients with NIDCM were divided into two subgroups: NIDCM with VAs and NIDCM without VAs. From CMR-FT, the global peak radial strain (GPRS), global longitudinal strain (GPLS), and global peak circumferential strain (GPCS) were calculated respectively from left ventricle (LV) model. We investigated the possible predictors of NIDCM combined with VAs by univariate and multivariate logistic regression analyses. Results: The percent LGE (15.51±3.30 vs. 9.62±2.18, P<0.001) was higher in NIDCM patients with VAs than in NIDCM patients without VAs. Furthermore, the NIDCM patients complicated with VAs had significantly lower GPCS compared with the NIDCM patients without VAs (P< 0.05). Subgroup analysis based on LGE negative, the NIDCM patients complicated with VAs had significantly lower GPRS,GPCS,GPLS compared with the NIDCM patients without VAs (P<0.05 for all). Multivariate analysis showed that both GPCS and % LGE were independent predictors of NIDCM combined with VAs. Conclusions: CMR global strain can early differentiate of NIDCM patients complicated with VAs specifically when LGE was not present. GPCS < −13.19% and % LGE > 10.37% are independent predictors of NIDCM combined with VAs.
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Ma et al. (2023) conducted an observational in Nonischemic dilated cardiomyopathy (NIDCM) (n=263). Cardiovascular magnetic resonance feature tracking (CMR-FT) vs. NIDCM patients without VAs was evaluated on Malignant ventricular arrhythmias (VAs) (p=<0.001). Global peak circumferential strain < -13.19% and late gadolinium enhancement > 10.37% independently predicted malignant ventricular arrhythmias in nonischemic dilated cardiomyopathy patients.
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