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CMR Risk Stratification for Dilated Cardiomyopathy with LVEF≥35%: Cohort Study with a Midterm Follow-up
Shuang Li1, Wenjing Yang1, Di Zhou1, Yining Wang1, Xiaohan Fan1, Arlene Sirajuddin2, Andrew E. Arai2, Shihua Zhao1, and Minjie Lu1
1fuwai hospital, Beijing, China, 2National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, MD, United States

Synopsis

This study aims to identify the risk factors for adverse events in dilated cardiomyopathy (DCM) patients with LVEF≥35% and establish a scoring model to predict adverse event risk. 269 consecutive DCM patients with LVEF ≥35% who underwent gadolinium-enhanced cardiac magnetic resonance (CMR) imaging were enrolled in this study. The primary endpoint was a composite of SCD or aborted SCD. Secondary endpoints were all-cause mortality, heart transplantation and hospitalization for heart failure. The nomogram we created using these parameters provides a novel way to clinically assess and risk stratify this patient population.

Abstract

Objectives: This study aims to identify the risk factors for adverse events in dilated cardiomyopathy (DCM) patients with LVEF≥35% and establish a scoring model to predict adverse event risk. Background: Recent studies have shown that still a considerable number of patients who succumbed to sudden cardiac death with LVEF≥35%. Methods: 269 consecutive DCM patients (206 men, 44±14 years) with LVEF ≥35% who underwent gadolinium-enhanced cardiac magnetic resonance (CMR) imaging were enrolled in this study. The primary endpoint was a composite of SCD or aborted SCD. Secondary endpoints were all-cause mortality, heart transplantation and hospitalization for heart failure. Risk factors for primary and secondary endpoints were identified by multivariate cox analysis and used to create a nomogram. Results: During a mean follow-up period of 88.6±24.7 months, a total of 34 and 51 patients reached the primary and secondary endpoints, respectively. Multivariate stepwise analyses showed that age (hazard ratio, HR=1.035; 95%CI, 1.007-1.065), family history of SCD (HR=3.729; 95%CI, 1.271-10.940), NYHA (HR=2.054; 95%CI, 1.096-4.099) and late gadolinium enhancement (LGE)≥ 9.0% (HR=9.101; 95%CI, 3.539-23.407) had significant prognostic associations with the primary endpoints (all p<0.05). NYHA (HR=1.944; 95%CI, 1.112-3.399), left atrium volume index (LAVi) >51.8ml/m2 (HR=1.949; 95%CI, 1.118-3.397), LGE≥8.8% (HR=2.770; 95%CI, 1.556-4.900) and global longitudinal strain (GLS) ≥-8.5% (HR=2.610; 95%CI, 1.491-4.568) had significant prognostic associations with the secondary endpoints (all p<0.05). Nomograms for adverse events were created by using these factors. Conclusions: The nomogram we created using these parameters provides a novel way to clinically assess and risk stratify this patient population.

Acknowledgements

None

References

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Proc. Intl. Soc. Mag. Reson. Med. 30 (2022)
4771
DOI: https://doi.org/10.58530/2022/4771