Heart failure & cardiomyopathies
Prognosis and Risk Stratification in Dilated Cardiomyopathy With Left Ventricular Ejection Fraction (LVEF)≤35%: Cardiac MRI Insights for Better Outcomes
Authors' conclusion
Patients with dilated cardiomyopathy with late gadolinium enhancement≥7.5% were at heightened risk of SCD events, which can be used for risk assessment. Risk stratifications for SCD, combining clinical and cardiac magnetic resonance imaging may potentially guide decision-making for implantable cardioverter defibrillator therapy.
Study context
- Population
- Patients with dilated cardiomyopathy with LVEF≤35% who underwent cardiac magnetic resonance imaging
- Participants
- 1,272 patients
- Exposure
- Clinical and cardiac magnetic resonance imaging predictors of sudden cardiac death (SCD) or aborted SCD
- Outcome
- Composite of:
- SCD
- Aborted SCD
- Follow-up
- Median 86.3 months
Methodological detailsconsecutively enrolled
- Consecutively enrolled
Main finding
As reported in the abstract
Estimate (95% CI)P value
Age
HR 1.02 years(1.01–1.04)
P = 0.006Family history of SCD
HR 2.00(1.01–3.98)
P = 0.05NT-proBNP
HR 2.02(1.18–3.44)
P = 0.01LVEF
HR 0.79 per 5%(0.66–0.95)
P = 0.01Late gadolinium enhancement≥7.5%
HR 4.11(2.72–6.21)
P < 0.001Per 5%, as printed
- Patients reached the primary end point
- 101
Observational data: associations, not effects.
Secondary outcomes
Composite of heart failure death and heart transplantation (secondary end point)
| Adjusted HR (95% CI) | P value | ||
|---|---|---|---|
| Left atrial volume index≥68.3 mL/m 2Independent predictor | 1.65 (1.13–2.40) | P = 0.009 | |
| 0.512Adjusted hazard ratio (log scale) |
SCD events, late gadolinium enhancement≥7.5% and LVEF≤20% vs late gadolinium enhancement<7.5%
- Higher risk of experiencing SCD events
- 7.12-fold
- Annual event rate
- 4.8%
- Competing Cox analysis
Original publication
Prognosis and Risk Stratification in Dilated Cardiomyopathy With LVEF≤35%: Cardiac MRI Insights for Better Outcomes. Circ Cardiovasc Imaging. Published 18 March 2025. doi:10.
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