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Journal Articles Journal of Cardiovascular Magnetic Resonance Year : 2023

Prognostic value of cardiovascular magnetic resonance T1 mapping and extracellular volume fraction in nonischemic dilated cardiomyopathy

1 CRMBM - Centre de résonance magnétique biologique et médicale
2 CEMEREM - Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - APHM]
3 MITOVASC - MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale
4 CHU Angers - Centre Hospitalier Universitaire d'Angers
5 LTSI - Laboratoire Traitement du Signal et de l'Image
6 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
7 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
8 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
9 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
10 ImViA - Imagerie et Vision Artificielle [Dijon]
11 CHU Dijon
12 ISSPAM - Institut des sciences de la santé publique [Marseille]
13 SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
14 TIMONE - Hôpital de la Timone [CHU - APHM]
15 BiosTIC - Biostatistique et technologies de l'information et de la communication (BioSTIC) - [Hôpital de la Timone - APHM]
16 VITROME - Vecteurs - Infections tropicales et méditerranéennes
17 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
18 HCL - Hospices Civils de Lyon
19 Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois]
20 CH Vichy - Centre Hospitalier de Vichy
21 EnVI - Endothélium, valvulopathies et insuffisance cardiaque
22 CHU Rouen
23 CHU Montpellier
24 CREATIS - Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé
25 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
26 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
27 Hôpital Nord [CHU - APHM]
28 MEPHI - Microbes évolution phylogénie et infections

Abstract

Abstract Background Heart failure- (HF) and arrhythmia-related complications are the main causes of morbidity and mortality in patients with nonischemic dilated cardiomyopathy (NIDCM). Cardiovascular magnetic resonance (CMR) imaging is a noninvasive tool for risk stratification based on fibrosis assessment. Diffuse interstitial fibrosis in NIDCM may be a limitation for fibrosis assessment through late gadolinium enhancement (LGE), which might be overcome through quantitative T1 and extracellular volume (ECV) assessment. T1 and ECV prognostic value for arrhythmia-related events remain poorly investigated. We asked whether T1 and ECV have a prognostic value in NIDCM patients. Methods This prospective multicenter study analyzed 225 patients with NIDCM confirmed by CMR who were followed up for 2 years. CMR evaluation included LGE, native T1 mapping and ECV values. The primary endpoint was the occurrence of a major adverse cardiovascular event (MACE) which was divided in two groups: HF-related events and arrhythmia-related events. Optimal cutoffs for prediction of MACE occurrence were calculated for all CMR quantitative values. Results Fifty-eight patients (26%) developed a MACE during follow-up, 42 patients (19%) with HF-related events and 16 patients (7%) arrhythmia-related events. T1 Z-score (p = 0.008) and global ECV (p = 0.001) were associated with HF-related events occurrence, in addition to left ventricular ejection fraction (p < 0.001). ECV > 32.1% (optimal cutoff) remained the only CMR independent predictor of HF-related events occurrence (HR 2.15 [1.14–4.07], p = 0.018). In the arrhythmia-related events group, patients had increased native T1 Z-score and ECV values, with both T1 Z-score > 4.2 and ECV > 30.5% (optimal cutoffs) being independent predictors of arrhythmia-related events occurrence (respectively, HR 2.86 [1.06–7.68], p = 0.037 and HR 2.72 [1.01–7.36], p = 0.049). Conclusions ECV was the sole independent predictive factor for both HF- and arrhythmia-related events in NIDCM patients. Native T1 was also an independent predictor in arrhythmia-related events occurrence. The addition of ECV and more importantly native T1 in the decision-making algorithm may improve arrhythmia risk stratification in NIDCM patients. Trial registration NCT02352129. Registered 2nd February 2015—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02352129
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hal-03978154 , version 1 (08-02-2023)
hal-03978154 , version 2 (03-04-2023)

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Farah Cadour, Morgane Quemeneur, Loic Biere, Erwan Donal, Zakarya Bentatou, et al.. Prognostic value of cardiovascular magnetic resonance T1 mapping and extracellular volume fraction in nonischemic dilated cardiomyopathy. Journal of Cardiovascular Magnetic Resonance, 2023, 25 (1), pp.7. ⟨10.1186/s12968-023-00919-y⟩. ⟨hal-03978154v2⟩
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