Key result
Dilated cardiomyopathy is linked to ~23-point lower myocardial external efficiency compared to healthy controls.
Why the study?
Myocardial oxygen metabolism and mechano-energetic efficiency are key determinants of cardiac function and outcomes, but their status in dilated cardiomyopathy remains incompletely understood.
Does non-contrast CMR reveal differences in myocardial oxygen metabolism and energy efficiency between patients with dilated cardiomyopathy and healthy controls?
Case-Control (n=72)
Does non-contrast CMR reveal differences in myocardial oxygen metabolism and energy efficiency between patients with dilated cardiomyopathy and healthy controls?
Absolute Event Rate: 22.88% vs 45.95%
p-value: p=<0.001
A non-contrast CMR technique successfully identifies impaired resting myocardial oxygen metabolism and reduced energy efficiency in patients with dilated cardiomyopathy, with women showing less severe impairment than men.
BACKGROUND: Myocardial oxygen metabolism and mechano-energetic efficiency are key determinants of cardiac function and clinical outcomes, but their status in dilated cardiomyopathy (DCM) remains incompletely understood. This study applied a non-contrast cardiovascular magnetic resonance (CMR) technique to assess myocardial oxygenation, cardiac work, and energy efficiency in DCM. METHODS: We enrolled 49 DCM patients and 23 age- and sex- matched controls. All subjects underwent cine CMR imaging for left ventricular ejection fraction (LVEF) and global longitudinal strain (LVGLS), pre- and post-contrast T1 mapping for extracellular volume (ECV), and first-pass perfusion imaging for semi-quantification of myocardial blood flow (MBF). A non-contrast CMR technique was applied to quantify myocardial oxygen extraction fraction (mOEF). Semi-quantitative myocardial oxygen consumption (MVO₂), external work (EW), and myocardial external efficiency (MEE) were derived for analysis. RESULTS: , p < 0.001), and MEE (22.88 ± 10.62% vs. 45.95 ± 10.53%, p < 0.001), but higher total MVO₂ (7.99 ± 2.58 vs. 5.30 ± 1.48, p < 0.001). Resting mOEF showed no significant association with LVEF and LVGLS, whereas total MVO₂ and MEE correlated significantly with both LVEF and LVGLS. Female DCM patients exhibited higher LVEF (31.30 ± 10.18% vs. 22.47 ± 9.74%, p = 0.006), absolute LVGLS (9.81 ± 3.55% vs. 7.24 ± 2.86%, p = 0.011) and MEE (27.29 ± 11.87% vs. 20.74 ± 9.43%, p = 0.049) compared with males. CONCLUSION: This feasibility study demonstrates the potential of this non-contrast CMR technique for noninvasive assessment of myocardial oxygen metabolism and mechano-energetic coupling in DCM. Patients with DCM showed impaired resting myocardial oxygen metabolism and reduced energy efficiency.
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Dai et al. (2026) conducted a case-control in Dilated cardiomyopathy (n=72). Dilated cardiomyopathy vs. Age- and sex-matched controls was evaluated on Myocardial external efficiency (MEE) (p=<0.001). Patients with dilated cardiomyopathy demonstrated significantly lower myocardial external efficiency compared to controls (22.88% vs. 45.95%, p<0.001) and higher total myocardial oxygen consumption.
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