Cardiac magnetic resonance comparison of non-dilated and dilated cardiomyopathy: imaging features and prognostic predictors in non-dilated left ventricular cardiomyopathy
Objectives Non-dilated left ventricular cardiomyopathy (NDLVC) is a novel cardiomyopathy characterised by normal LV size and non-ischaemic myocardial scarring or fatty tissue replacement. This study aimed to explore the clinical and cardiac magnetic resonance (CMR) characteristics of NDLVC compared...
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| Format: | Article |
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BMJ Publishing Group
2025-06-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/12/1/e003441.full |
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| author | Hui Wang Lei Xu Shuang Li Hongkai Zhang Baiyan Zhuang Zhonghua Sun |
| author_facet | Hui Wang Lei Xu Shuang Li Hongkai Zhang Baiyan Zhuang Zhonghua Sun |
| author_sort | Hui Wang |
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| description | Objectives Non-dilated left ventricular cardiomyopathy (NDLVC) is a novel cardiomyopathy characterised by normal LV size and non-ischaemic myocardial scarring or fatty tissue replacement. This study aimed to explore the clinical and cardiac magnetic resonance (CMR) characteristics of NDLVC compared with dilated cardiomyopathy (DCM) and event rates of patients with NDLVC and reduced LV ejection fraction (NDLVC-REF).Materials and methods A retrospective cohort study of 396 patients, including 210 with NDLVC (135 classified as NDLVC-REF) and 186 with DCM, who underwent CMR imaging between 2015 and 2017, was conducted. Follow-up lasted until May 2024, with a composite endpoint of major adverse cardiovascular events (only NDLVC patients were followed).Results NDLVC patients exhibited better cardiac function than those with DCM, with higher LVEF (40.1%±15.8% vs 23.3%±8.8%, p<0.001). Compared with DCM, the presence of late gadolinium enhancement (LGE) was lower in the NDLVC group (77.4% vs 64.8%, p<0.001). NDLVC-REF showed a comparable prevalence of LGE presence with DCM (70.4% vs 77.4%, p=0.06) but lower LGE mass (4.8 (0, 9.9) g vs 6.8 (4.0, 11.0) g, p=0.01). Over a median follow-up of 83 months, 62 patients with NDLVC (29.5%) reached the composite endpoint. Multivariable analyses (forward logistic regression) identified right ventricular ejection fraction (RVEF) (0.98 (0.96, 0.99), p=0.01, Harrell’s C-index=0.65) as the significant predictor of adverse outcomes in NDLVC. The presence of epicardium-involved LGE, left atrial volume index, LVEF, global radial strain and global circumferential strain was also associated with adverse events in NDLVC. In NDLVC-REF, RVEF <40% independently predicted major adverse cardiovascular events (2.19 (1.14–4.20), p=0.01).Conclusion The clinical baseline and CMR parameters of NDLVC were different from those of DCM. RVEF was a powerful predictor of adverse events in NDLVC and NDLVC-REF. |
| format | Article |
| id | doaj-art-44dfc8f352784e23af79a36f0b73f203 |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-44dfc8f352784e23af79a36f0b73f2032025-08-20T03:30:41ZengBMJ Publishing GroupOpen Heart2053-36242025-06-0112110.1136/openhrt-2025-003441Cardiac magnetic resonance comparison of non-dilated and dilated cardiomyopathy: imaging features and prognostic predictors in non-dilated left ventricular cardiomyopathyHui Wang0Lei Xu1Shuang Li2Hongkai Zhang3Baiyan Zhuang4Zhonghua Sun5Department of Radiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Capital Medical University, Beijing, ChinaDepartment of Radiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Capital Medical University, Beijing, ChinaDepartment of Radiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Capital Medical University, Beijing, ChinaDepartment of Radiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Capital Medical University, Beijing, ChinaDepartment of Radiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Capital Medical University, Beijing, ChinaMedical Radiation Science, Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, Western Australia, AustraliaObjectives Non-dilated left ventricular cardiomyopathy (NDLVC) is a novel cardiomyopathy characterised by normal LV size and non-ischaemic myocardial scarring or fatty tissue replacement. This study aimed to explore the clinical and cardiac magnetic resonance (CMR) characteristics of NDLVC compared with dilated cardiomyopathy (DCM) and event rates of patients with NDLVC and reduced LV ejection fraction (NDLVC-REF).Materials and methods A retrospective cohort study of 396 patients, including 210 with NDLVC (135 classified as NDLVC-REF) and 186 with DCM, who underwent CMR imaging between 2015 and 2017, was conducted. Follow-up lasted until May 2024, with a composite endpoint of major adverse cardiovascular events (only NDLVC patients were followed).Results NDLVC patients exhibited better cardiac function than those with DCM, with higher LVEF (40.1%±15.8% vs 23.3%±8.8%, p<0.001). Compared with DCM, the presence of late gadolinium enhancement (LGE) was lower in the NDLVC group (77.4% vs 64.8%, p<0.001). NDLVC-REF showed a comparable prevalence of LGE presence with DCM (70.4% vs 77.4%, p=0.06) but lower LGE mass (4.8 (0, 9.9) g vs 6.8 (4.0, 11.0) g, p=0.01). Over a median follow-up of 83 months, 62 patients with NDLVC (29.5%) reached the composite endpoint. Multivariable analyses (forward logistic regression) identified right ventricular ejection fraction (RVEF) (0.98 (0.96, 0.99), p=0.01, Harrell’s C-index=0.65) as the significant predictor of adverse outcomes in NDLVC. The presence of epicardium-involved LGE, left atrial volume index, LVEF, global radial strain and global circumferential strain was also associated with adverse events in NDLVC. In NDLVC-REF, RVEF <40% independently predicted major adverse cardiovascular events (2.19 (1.14–4.20), p=0.01).Conclusion The clinical baseline and CMR parameters of NDLVC were different from those of DCM. RVEF was a powerful predictor of adverse events in NDLVC and NDLVC-REF.https://openheart.bmj.com/content/12/1/e003441.full |
| spellingShingle | Hui Wang Lei Xu Shuang Li Hongkai Zhang Baiyan Zhuang Zhonghua Sun Cardiac magnetic resonance comparison of non-dilated and dilated cardiomyopathy: imaging features and prognostic predictors in non-dilated left ventricular cardiomyopathy Open Heart |
| title | Cardiac magnetic resonance comparison of non-dilated and dilated cardiomyopathy: imaging features and prognostic predictors in non-dilated left ventricular cardiomyopathy |
| title_full | Cardiac magnetic resonance comparison of non-dilated and dilated cardiomyopathy: imaging features and prognostic predictors in non-dilated left ventricular cardiomyopathy |
| title_fullStr | Cardiac magnetic resonance comparison of non-dilated and dilated cardiomyopathy: imaging features and prognostic predictors in non-dilated left ventricular cardiomyopathy |
| title_full_unstemmed | Cardiac magnetic resonance comparison of non-dilated and dilated cardiomyopathy: imaging features and prognostic predictors in non-dilated left ventricular cardiomyopathy |
| title_short | Cardiac magnetic resonance comparison of non-dilated and dilated cardiomyopathy: imaging features and prognostic predictors in non-dilated left ventricular cardiomyopathy |
| title_sort | cardiac magnetic resonance comparison of non dilated and dilated cardiomyopathy imaging features and prognostic predictors in non dilated left ventricular cardiomyopathy |
| url | https://openheart.bmj.com/content/12/1/e003441.full |
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