Key result
CMR-derived perfusion reserve, LVEF, and extracellular volume link to exercise capacity in dilated cardiomyopathy.
Why the study?
Aerobic exercise capacity predicts mortality in DCM, but the central mechanisms contributing to exercise intolerance remain unknown.
Case-Control (n=132)
No
Coronary microvascular dysfunction is present in dilated cardiomyopathy, and myocardial perfusion reserve alongside ejection fraction and diffuse fibrosis is an independent predictor of aerobic exercise capacity.
May link microvascular dysfunction to exercise limitation in DCM; hypothesis-generating and requires prospective trials before clinical adoption.
BACKGROUND: Aerobic exercise capacity is an independent predictor of mortality in dilated cardiomyopathy (DCM), but the central mechanisms contributing to exercise intolerance in DCM are unknown. The aim of this study was to characterize coronary microvascular function in DCM and determine if cardiovascular magnetic resonance (CMR) measures are associated with aerobic exercise capacity. METHODS: . CONCLUSION: In comparison to controls, DCM patients have lower stress myocardial blood flow and MPR. In DCM, MPR, LV ejection fraction, and fibrosis are independently associated with aerobic exercise capacity.
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Dattani et al. (2024) conducted a case-control in Dilated cardiomyopathy (DCM) (n=132). Dilated cardiomyopathy (Coronary microvascular dysfunction) vs. Propensity-matched healthy controls was evaluated on Independent association of myocardial perfusion reserve (MPR), LV ejection fraction, and extracellular volume (ECV) with aerobic exercise capacity (percentage-predicted peak VO2) via multivariable linear regression (R2 = 0.531, p=<0.001). In patients with dilated cardiomyopathy, myocardial perfusion reserve, LV ejection fraction, and extracellular volume were independently associated with aerobic exercise capacity (R2 = 0.531, p<0.001).
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