Heart failure & cardiomyopathies
Phenotypic stratification and prognostic value of cardiac magnetic resonance in non-dilated left ventricular cardiomyopathy
Authors' conclusion
CMR phenotyping enables risk stratification in NDLVC. LGE extent provides an objective marker to identify high-risk patients-even with preserved ejection fraction-supporting its integration into routine evaluation.
Study context
- Population
- Patients with non-dilated left ventricular cardiomyopathy (NDLVC), characterised by non-ischaemic scar/fatty replacement or isolated systolic dysfunction without dilatationpatients with NDLVC (mean age 45 (16) years)
- Participants
- 515 patients
- Comparison
- Three CMR-defined phenotypes: LGE+/H- vs LGE-/H+ vs LGE+/H+
- LGE+/H-n = 130
- LGE-/H+n = 226
- LGE+/H+n = 159
- Outcome
- All-cause death/heart transplantation
- Follow-up
- Mean 6.5 (1.9) years
Methodological detailsmultivariable analysis, univariable Cox regression analysis
- Multivariable analysis
- Univariable Cox regression analysis
Main finding
As reported in the abstract
Estimate (95% CI)P value
New York Heart Association class >II
HR 3.42(1.58–7.39)
P = 0.002LVEF
HR 0.91 per 1% increase(0.88–0.95)
P < 0.001LGE extent
HR 1.14 per 3% increase(1.07–1.21)
P < 0.001Each row per its own increment, as printed
- Patients reaching the primary endpoint
- 29 patients (5.6%)
- C-statistic of the model
- 0.862
Secondary outcomes
| Outcome | HR (per 3%) (95% CI) | P value | |
|---|---|---|---|
| HF events · mean follow-up of 6.5 (1.9) yearsAdjusted model · secondary endpoint | 1.11 (1.06–1.17) | P < 0.001 | |
| Malignant ventricular arrhythmia (MVA) · mean follow-up of 6.5 (1.9) yearsUnivariable Cox regression analysis · secondary endpoint | 1.12 (1.02–1.23) | P = 0.021 | |
| 0.512Hazard ratio (log scale) |
- Heart failure (HF) events — Patients experiencing HF
- 81 (15.7%)
- Malignant ventricular arrhythmia (MVA) — Patients experiencing MVA
- 19 (3.7%)
Composite clinical endpoints by phenotype
- LGE+/H+ subgroup demonstrated the highest risk for composite clinical endpoints compared with other phenotypic groups
- P < 0.001
Original publication
Phenotypic stratification and prognostic value of cardiac magnetic resonance in non-dilated left ventricular cardiomyopathy. Heart. Published 17 August 2025. doi:10.
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