Background
Methods
Study design and patient selection
Data acquisition
CMR protocol and image analysis
Patient follow-up and endpoints of the study
Statistical analysis
Results
Patient characteristics
All patients (n = 86) | |
---|---|
Nonischemic cardiomyopathy* | 65 (76) |
Inflammatory cardiomyopathy | 23 (27) |
Dilated cardiomyopathy | 22 (26) |
Cardiomyopathy nonspecific | 8 (9) |
Infiltrative cardiomyopathy or storage disease | 5 (6) |
Noncompaction cardiomyopathy | 3 (3) |
Hypertrophic cardiomyopathy | 2 (2) |
Tako-Tsubo cardiomyopathy | 1 (1) |
Ion channelopathy (Long-QT syndrome) | 1 (1) |
Other diagnoses
| 21 (24) |
Left ventricular hypertrophy** | 15 (17) |
Idiopathic arrhythmia | 6 (7) |
All patients (n = 86) | LGE negative (n = 25) | LGE positive (n = 61) | p-value | SWMA negative (n = 30) | SWMA positive (n = 56) | p-value | |
---|---|---|---|---|---|---|---|
Demographics
| |||||||
Age, year | 53 (42–61) | 49 (42–59) | 53 (42–63) | 0.278 | 51 (42–59) | 53 (42–62) | 0.336 |
Gender, female | 39 (45) | 15 (60) | 24 (39) | 0.131 | 20 (67) | 19 (34) | 0.007 |
Cardiovascular risk factors
| |||||||
Dyslipidemia | 51 (59) | 14 (56) | 37 (61) | 0.871 | 17 (57) | 34 (61) | 0.893 |
Hypertension | 34 (40) | 7 (28) | 27 (44) | 0.247 | 10 (33) | 24 (43) | 0.529 |
Diabetes | 7 (8) | 2 (8) | 5 (8) | 1.000 | 0 (0) | 7 (13) | 0.108 |
Smoking | 19 (22) | 6 (24) | 13 (21) | 1.000 | 6 (20) | 13 (23) | 0.944 |
Family risk for CAD | 11 (13) | 5 (20) | 6 (10) | 0.285 | 5 (17) | 6 (11) | 0.504 |
Sum of risk factors | 1 (1–2) | 1 (0–2) | 1 (1–2) | 0.513 | 1 (1–2) | 1 (1–2) | 0.406 |
Symptoms
| |||||||
Syncope or presyncope | 21 (24) | 9 (36) | 12 (20) | 0.185 | 9 (30) | 12 (21) | 0.536 |
Palpitation | 34 (40) | 13 (52) | 21 (34) | 0.204 | 14 (47) | 20 (36) | 0.448 |
Chest pain | 31 (36) | 9 (36) | 22 (36) | 1.000 | 12 (40) | 19 (34) | 0.746 |
NYHA-class | 2 (1–3) | 1 (1–2) | 2 (1–4) | 0.001 | 1 (1–2) | 2 (1–4) | 0.001 |
Congestive heart failure
| 38 (44) | 4 (16) | 34 (56) | 0.002 | 2(7) | 36 (64) | < 0.001 |
Arrhythmias
| |||||||
Atrial fibrillation | 25 (29) | 6 (24) | 19 (31) | 0.688 | 5 (17) | 20 (36) | 0.109 |
Ventricular fibrillation | 9 (10) | 3 (12) | 6 (10) | 0.715 | 3 (10) | 6 (11) | 1.000 |
Sustained VT | 9 (10) | 1 (4) | 8 (13) | 0.274 | 1 (3) | 8 (14) | 0.152 |
Nonsustained VT | 16 (19) | 6 (24) | 10 (16) | 0.542 | 5 (17) | 11 (20) | 0.962 |
Conducting abnormalities
| |||||||
AVB of any grade | 39 (45) | 7 (28) | 32 (53) | 0.067 | 9 (30) | 30 (54) | 0.062 |
Distal AVB | 7 (8) | 3 (12) | 4 (7) | 0.409 | 3 (10) | 4 (7) | 0.691 |
Cardiac enzyme elevation* | 32 (37) | 8 (32) | 24 (39) | 0.693 | 9 (30) | 23 (41) | 0.436 |
All patients (n = 86) | LGE negative (n = 25) | LGE positive (n = 61) | p-value | SWMA negative (n = 30) | SWMA positive (n = 56) | p-value | |
---|---|---|---|---|---|---|---|
Echocardiography
| |||||||
LVEDD, mm | 55 (48–61) | 48 (44–54) | 56 (50–63) | < 0.001 | 48 (44–54) | 59 (53–67) | < 0.001 |
LVEF, % | 50 (33–62) | 62 (57–71) | 42 (25–56) | < 0.001 | 63 (60–70) | 38 (23–52) | < 0.001 |
CMR
| |||||||
LVEDV, ml/m2 | 78 (64–110) | 71 (60–82) | 87 (66–111) | 0.050 | 68 (60–76) | 97 (69–120) | < 0.001 |
LVESV, ml/m2 | 36 (25–69) | 26 (21–32) | 46 (30–73) | 0.001 | 25 (20–31) | 55 (35–85) | < 0.001 |
SV, ml | 73 (58–85) | 75 (65–89) | 72 (55–84) | 0.227 | 76 (65–82) | 70 (52–88) | 0.291 |
LVEF, % | 52 (35–61) | 60 (56–69) | 45 (32–58) | < 0.001 | 65 (59–69) | 42 (30–53) | < 0.001 |
LGE presence | 61 (71) | - | - | - | 9 (30) | 52 (93) | < 0.001 |
LGE extent, score | 5 (0–17) | - | 9 (4–22) | - | 0 (0–2) | 11 (4–23) | < 0.001 |
LGE extent, % LV volume | 7 (0–25) | - | 13 (6–32) | - | 0 (0–3) | 16 (6–34) | < 0.001 |
SWMA, presence | 56 (65) | 4 (16) | 52 (85) | < 0.001 | - | - | - |
SWMA extent, score | 4 (0–12) | 0 (0–0) | 5 (3–17) | < 0.001 | - | 7 (4–19) | - |
Follow-up
HR | 95% CI | p-value | |
---|---|---|---|
Demographics
| |||
Age, year | 1.020 | 0.980 - 1.060 | 0.333 |
Gender, female | 1.094 | 0.397 - 3.016 | 0.863 |
Symptoms
| |||
Syncope or presyncope | 1.093 | 0.348 - 3.434 | 0.879 |
Palpitation | 1.369 | 0.497 - 3.777 | 0.544 |
Chest pain | 0.837 | 0.286 - 2.449 | 0.745 |
NYHA-class (III - IV) | 2.820 | 1.003 - 7.928 | 0.049 |
Congestive heart failure
| 2.704 | 0.924 - 7.913 | 0.069 |
Arrhythmias
| |||
Atrial fibrillation | 2.256 | 0.818 - 6.223 | 0.116 |
Ventricular fibrillation | 0.559 | 0.073 - 4.250 | 0.574 |
Sustained VT | 3.807 | 1.207 - 12.013 | 0.023 |
Nonsustained VT | 1.122 | 0.317 - 3.975 | 0.859 |
Conducting abnormalities
| |||
AVB of any grade | 3.801 | 1.210 - 11.945 | 0.022 |
Distal AVB | 0.758 | 0.100 - 5.764 | 0.789 |
Cardiac enzyme elevation*
| 1.540 | 0.558 - 4.247 | 0.404 |
CMR
| |||
LVEDV, ml/m2 | 1.004 | 0.991 - 1.016 | 0.556 |
LVESV, ml/m2 | 1.008 | 0.996 - 1.020 | 0.213 |
SV, ml | 0.968 | 0.940 - 0.997 | 0.032 |
LVEF, % | 0.959 | 0.930 - 0.990 | 0.009 |
LVEF < 50% | 3.813 | 1.213 -11.981 | 0.022 |
LGE, presence | 6.329 | 0.832 - 48.143 | 0.075 |
LGE, extent, score | 1.042 | 1.019 - 1.065 | < 0.001 |
LGE, extent, % LV volume | 1.028 | 1.013 - 1.044 | < 0.001 |
SWMA, presence** | 0.002 | ||
SWMA, extent, score | 1.067 | 1.014 - 1.122 | 0.012 |
HR | 95% CI | p-value | |
---|---|---|---|
Model (forward stepwise) | |||
LGE extent, % LV volume | 1.027 | 1.009 - 1.044 | 0.003 |
Sustained VT | 4.793 | 1.428 - 16.087 | 0.011 |
LVEF (CMR), % | 0.962 | 0.929 - 0.997 | 0.034 |