Author + information
- Elliott Elias,
- Eduardo Pozo,
- Vijayapraveena Paruchuri,
- Juan Gaztanaga,
- Jill Kalman,
- Jagat Narula,
- Valentin Fuster and
- Javier Sanz
Cardiac magnetic resonance (CMR) is often used in the evaluation of patients with non-ischemic dilated cardiomyopathy (NIDCM), and can quantify diffuse interstitial fibrosis. We aimed to identify CMR variables for potential risk stratification, including T1 mapping, in NIDCM.
Patients with NIDCM and left ventricular (LV) ejection fraction <40% referred for CMR were retrospectively identified. LV and right ventricular (RV) end-systolic and end-diastolic volumes, ejection fraction, LV mass, and the presence of late gadolinium enhancement (LGE) were determined from CMR images. Septal post-contrast T1 mapping was performed on validated Look-Locker sequences. Incident death or cardiac hospital admission was obtained from hospital records.
113 patients (75 males [67%], age 58 ± 16 years) were studied. LV and RV ejection fraction, RV volumes, the presence of LGE, and septal post-contrast T1 times were significantly different between those with and without incident events (Table). On multivariate analysis, only LGE (HR 10.3 95% C.I 1.2 [[Unable to Display Character: –]] 92.2; p = 0.037) and RV ejection fraction (HR for every 10% increase 0.58, 95% Cl 0.36–0.94; p = 0.026) were independent predictors of the composite outcome.
|LVEF(%)||28.0 ± 7.8||23.7 ± 7.8%||0.006|
|LVEDV (ml)||268.2 ± 90.4||268.0 ± 102.8||ns|
|LVESV (ml)||193.5 ± 83.3||210.4 ± 87.5||ns|
|LV mass (g)||177.7 ± 68.3||180.6 ± 59.0||ns|
|RVEF(%)||43.9 ± 13.5%||33.8 ± 13.5%||0.012|
|RVEDV (ml)||171.2 ± 63.0||216.7 ± 74.2||0.019|
|RVESV (ml)||100.5 ± 54.8||149.7 ± 74.2||0.007|
|T1 septum (ms)||295.7 ± 70.6||253.8 ± 62.9||0.002|
Abbreviations: LVEF – left ventricular ejection fraction; LVEDV – left ventricular end-diastolic volume; LVESV – left ventricular end-systolic volume; LV mass – left ventricular mass; RVEDV – right ventricular end-diastolic volume; RVESV – right ventricular end-systolic volume; RVEF – right ventricular ejection fraction; T1 septum – post-contrast mapped T1 values of interventricular septum; LGE (+) – presence of late gadolinium enhancement; ns = not significant
In patients with NIDCM and moderate to severe LV dysfunction, increased interstitial fibrosis is associated with impaired outcome. However, after adjusting for additional covariates, only the presence of LGE and RV dysfunction remain independent predictors of events.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: New Diagnostic and Imaging Strategies in Heart Failure
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1136-307
- 2013 American College of Cardiology Foundation