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Erschienen in:
24.04.2017 | Cardiac
Contrast-enhanced T1 mapping-based extracellular volume fraction independently predicts clinical outcome in patients with non-ischemic dilated cardiomyopathy: a prospective cohort study
Erschienen in: European Radiology | Ausgabe 9/2017
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Objectives
We aimed to evaluate the prognostic role of cardiac magnetic resonance imaging (CMR)–based extracellular volume fraction (ECV) in patients with non-ischemic dilated cardiomyopathy (NIDCM) and compare it with late gadolinium enhancement (LGE) parameters.
Methods
This was a single-center, prospective, cohort study of 117 NIDCM patients (71 men, 51.9 ± 16.7 years) who underwent clinical 3.0-T CMR. Myocardial ECV and LGE were quantified on the left ventricular myocardium. The presence of midwall LGE was also detected. Nineteen healthy subjects served as controls. The primary end points were cardiovascular (CV) events defined by CV death, rehospitalization due to heart failure, and heart transplantation.
Results
During the follow-up period (median duration, 11.2 months; 25th–75th percentile, 7.8–21.9 months), the primary end points occurred in 19 patients (16.2%). The ECV (per 3% and 1% increase) was associated with a hazard ratio of 1.80 and 1.22 (95% confidence interval [CI], 1.48–2.20 and 1.14–1.30, respectively; p < 0.001) for the CV events. Multivariable analysis also indicated that ECV was an independent prognostic factor and had a higher prognostic value (Harrell’s c statistic, 0.88) than LGE quantification values (0.77) or midwall LGE (0.80).
Conclusion
CMR-based ECV independently predicts the clinical outcome in NIDCM patients.
Key Points
• T1-mapping–based ECV is a useful parameter of risk stratification in NIDCM
• ECV has a higher prognostic value than LGE
• Contrast-enhanced T1-mapping CMR is a feasible and safe method