Key result
Integrating cardiac magnetic resonance, late gadolinium enhancement, and genotype data improves sudden cardiac death prediction in early non-ischaemic cardiomyopathy compared to LVEF alone.
Why the study?
Traditional risk stratification based on LVEF inadequately captures arrhythmic risk in early non-ischaemic cardiomyopathy, prompting exploration of multimodal strategies integrating genetics and imaging.
Does multimodal risk assessment integrating imaging and genetic data improve prediction of sudden cardiac death in early non-ischaemic cardiomyopathy compared to traditional LVEF-based stratification?
Does multimodal risk assessment integrating imaging and genetic data improve prediction of sudden cardiac death in early non-ischaemic cardiomyopathy compared to traditional LVEF-based stratification?
Integrating cardiovascular magnetic resonance imaging, late gadolinium enhancement, and genotype-specific phenotyping provides a more accurate, biologically informed framework for predicting sudden cardiac death in early non-ischaemic cardiomyopathy than traditional LVEF cut-offs.
May refine sudden cardiac death risk stratification beyond LVEF in early non-ischaemic cardiomyopathy; hypothesis-generating and requires prospective validation before practice change.
Preventing sudden cardiac death (SCD) in early non-ischaemic cardiomyopathy (NICM) remains a major clinical challenge. Traditional risk stratification centred on left ventricular ejection fraction (LVEF) poorly captures arrhythmic risk, particularly in early dilated cardiomyopathy (DCM) and non-dilated left ventricular cardiomyopathy (NDLVC). Increasing recognition of fibrosis-based and genotype-specific arrhythmogenic substrates has prompted a shift towards multimodal risk assessment strategies integrating imaging, electrocardiographic, and genetic data. This review examines contemporary approaches to risk stratification in early NICM, with particular emphasis on the role of cardiovascular magnetic resonance (CMR) imaging and late gadolinium enhancement (LGE). The expanding role of genotype-specific phenotyping is also explored, including high-risk arrhythmogenic variants and the integration of genotype with imaging phenotype as a promising route to improved prediction. Collectively, these advances support a transition from population-based LVEF thresholds towards more personalised and biologically informed strategies for prevention of SCD in early NICM.
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Kasiakogias et al. (2026) conducted a review in Early non-ischaemic cardiomyopathy. Multimodal risk assessment (imaging and genetics) vs. LVEF-centric assessment was evaluated. Integrating cardiac magnetic resonance, late gadolinium enhancement, and genotype data improves sudden cardiac death prediction in early non-ischaemic cardiomyopathy compared to LVEF alone.
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