Heart failure & cardiomyopathiesCohort study
Prognostic Value of Papillary Muscle Scarring in Patients With Dilated Cardiomyopathy
- Prospective cohort study
- single-centre
- consecutive patients
Authors' conclusion
In this single-center cohort study, papSCAR as detected by dark blood delayed-enhancement CMR was present in approximately one-third of patients with DCM and was independently associated with cardiac death.
Study context
- Population
- Consecutive patients with known or suspected dilated cardiomyopathy (DCM) referred for cardiovascular magnetic resonance (CMR), academic hospital in North Carolina, 2011–2020
- Participants
- 470 patients
- Exposure
- papSCAR vs no papSCAR
- PapSCARn = 137
- Outcome
- Cardiac mortality
- Follow-up
- Up to 8 years
Main finding
As reported in the abstract
Cardiac death
papSCAR vs No papSCARHazard ratio (95% CI)P value
unadjusted
2.30(1.34–3.95)
P = 0.002adjusted (age, SBP, heart rate, LVEF, midwall scar)
1.86(1.07–3.24)
P = 0.03- Incremental prognostic value (incremental χ2)
- 4.68; P = .03
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| HF events (HF death or cardiac transplant) · independently associated | 2.05 (1.16–3.61) | P = 0.01 | |
| Arrhythmia events (SCD or aborted SCD) · independently associated | 3.41 (1.46–7.94) | P = 0.005 | |
| 0.10.31310Hazard ratio (log scale) |
Mean
| Outcome | PapSCAR | No papSCAR | Estimate | P value |
|---|---|---|---|---|
| LVEF · similar | 30.7% (SD 11.0%) | 31.4% (SD 10.3%) | P = 0.52 |
- papSCAR prevalence
- 29.1% · 137 of 137
Original publication
Prognostic Value of Papillary Muscle Scarring in Patients With Dilated Cardiomyopathy. JAMA Cardiol. Published 1 December 2025. doi:10.1001/jamacardio.2025.3822
Summarised from the published abstract; every number is checked against it