PMID- 36318031
OWN - NLM
STAT- MEDLINE
DCOM- 20230223
LR  - 20240302
IS  - 1527-1315 (Electronic)
IS  - 0033-8419 (Print)
IS  - 0033-8419 (Linking)
VI  - 306
IP  - 3
DP  - 2023 Mar
TI  - Cardiac MRI Risk Stratification for Dilated Cardiomyopathy with Left Ventricular 
      Ejection Fraction of 35% or Higher.
PG  - e213059
LID - 10.1148/radiol.213059 [doi]
LID - e213059
AB  - Background Studies over the past 15 years have demonstrated that a considerable 
      number of patients with dilated cardiomyopathy (DCM) who died from sudden cardiac 
      death (SCD) had a left ventricular (LV) ejection fraction (LVEF) of 35% or 
      higher. Purpose To identify clinical and cardiac MRI risk factors for adverse 
      events in patients with DCM and LVEF of 35% or higher. Materials and Methods In 
      this retrospective study, consecutive patients with DCM and LVEF of 35% or higher 
      who underwent cardiac MRI between January 2010 and December 2017 were included. 
      The primary end point was a composite of SCD or aborted SCD. The secondary end 
      point was a composite of all-cause mortality, heart transplant, or 
      hospitalization for heart failure. The risk factors for the primary and secondary 
      end points were identified with multivariable Cox analysis. Results A total of 
      466 patients with DCM and LVEF of 35% or higher (mean age, 44 years +/- 14 [SD]; 
      358 men) were included. During a mean follow-up of 79 months +/- 30 (SD) (range, 
      7-143 months), 40 patients reached the primary end point and 61 reached the 
      secondary end point. In the adjusted analysis, age (hazard ratio [HR], 1.03 per 
      year [95% CI: 1.00, 1.05]; P = .04), family history of SCD (HR, 3.4 [95% CI: 1.3, 
      8.8]; P = .01), New York Heart Association (NYHA) class III or IV (HR vs NYHA 
      class I or II, 2.1 [95% CI: 1.1, 3.9]; P = .02), and myocardial scar at late 
      gadolinium enhancement (LGE) MRI greater than or equal to 7.1% of the LV mass 
      (HR, 4.4 [95% CI: 2.4, 8.3]; P < .001) were associated with SCD or aborted SCD. 
      For the composite secondary end point, LGE greater than or equal to 7.1% of the 
      LV mass (HR vs LGE <7.1%, 2.0 [95% CI: 1.2, 3.4]; P = .01), left atrial maximum 
      volume index, and reduced global longitudinal strain were independent predictors. 
      Conclusion For patients with dilated cardiomyopathy and left ventricular (LV) 
      ejection fraction of 35% or higher, cardiac MRI-defined myocardial scar greater 
      than or equal to 7.1% of the LV mass was associated with sudden cardiac death 
      (SCD) or aborted SCD. (c) RSNA, 2022 Online supplemental material is available for 
      this article.
FAU - Li, Shuang
AU  - Li S
AUID- ORCID: 0000-0002-0750-5779
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Wang, Yining
AU  - Wang Y
AUID- ORCID: 0000-0003-3288-7921
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Yang, Wenjing
AU  - Yang W
AUID- ORCID: 0000-0002-9929-5480
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Zhou, Di
AU  - Zhou D
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Zhuang, Baiyan
AU  - Zhuang B
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Xu, Jing
AU  - Xu J
AUID- ORCID: 0000-0003-1350-4489
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - He, Jian
AU  - He J
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Yin, Gang
AU  - Yin G
AUID- ORCID: 0000-0002-3122-992X
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Fan, Xiaohan
AU  - Fan X
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Wu, Weichun
AU  - Wu W
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Sharma, Piyush
AU  - Sharma P
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Sirajuddin, Arlene
AU  - Sirajuddin A
AUID- ORCID: 0000-0001-9183-5983
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Arai, Andrew E
AU  - Arai AE
AUID- ORCID: 0000-0002-5413-1466
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Zhao, Shihua
AU  - Zhao S
AUID- ORCID: 0000-0002-7798-0364
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
FAU - Lu, Minjie
AU  - Lu M
AUID- ORCID: 0000-0001-8696-318X
AD  - From the Department of Magnetic Resonance Imaging (S.L., Y.W., W.Y., D.Z., B.Z., 
      J.X., J.H., G.Y., S.Z., M.L.), Cardiac Arrhythmia Center (X.F.), and Department 
      of Echocardiography (W.W.), Fuwai Hospital, State Key Laboratory of 
      Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi 
      Rd, Beijing 100037, China; Department of Medicine, Saint James School of 
      Medicine, Park Ridge, Ill (P.S.); Department of Health and Human Services, 
      Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Md 
      (A.S.); Kensington, Md (A.E.A.); and Key Laboratory of Cardiovascular Imaging 
      (Cultivation), Chinese Academy of Medical Sciences, Beijing, China (G.Y., W.W., 
      M.L.).
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221101
PL  - United States
TA  - Radiology
JT  - Radiology
JID - 0401260
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Male
MH  - Humans
MH  - Adult
MH  - Stroke Volume
MH  - *Ventricular Function, Left
MH  - *Cardiomyopathy, Dilated/complications/diagnostic imaging
MH  - Retrospective Studies
MH  - Contrast Media
MH  - Cicatrix
MH  - Gadolinium
MH  - Magnetic Resonance Imaging
MH  - Risk Factors
MH  - Death, Sudden, Cardiac
MH  - Risk Assessment
MH  - Prognosis
MH  - Predictive Value of Tests
PMC - PMC9968772
COIS- Disclosures of conflicts of interest: S.L. No relevant relationships. Y.W. No 
      relevant relationships. W.Y. No relevant relationships. D.Z. No relevant 
      relationships. B.Z. No relevant relationships. J.X. No relevant relationships. 
      J.H. No relevant relationships. G.Y. No relevant relationships. X.F. No relevant 
      relationships. W.W. No relevant relationships. P.S. No relevant relationships. 
      A.S. No relevant relationships. A.E.A. Licensing fees from Circle Cardiovascular 
      Imaging; consulting fees from Bayer and Circle Cardiovascular Imaging; payment 
      for lectures from Radcliffe; patent pending for perfusion quantification; 
      participant on a data safety monitoring board or advisory board for the National 
      Institutes of Health. S.Z. No relevant relationships. M.L. No relevant 
      relationships.
EDAT- 2022/11/02 06:00
MHDA- 2023/02/25 06:00
PMCR- 2024/03/01
CRDT- 2022/11/01 10:05
PHST- 2022/11/02 06:00 [pubmed]
PHST- 2023/02/25 06:00 [medline]
PHST- 2022/11/01 10:05 [entrez]
PHST- 2024/03/01 00:00 [pmc-release]
AID - 10.1148/radiol.213059 [doi]
PST - ppublish
SO  - Radiology. 2023 Mar;306(3):e213059. doi: 10.1148/radiol.213059. Epub 2022 Nov 1.