Prognostic value of left ventricular remodelling index in idiopathic dilated cardiomyopathy. (13th July 2020)

• Record Type: Journal Article
• Authors: Xu, Yuanwei; Lin, Jiayi; Liang, Yaodan; Wan, Ke; Li, Weihao; Wang, Jie; Zhu, Yanjie; Mui, David; Wang, Lili; Li, Yuancheng; Cheng, Wei; Sun, Jiayu; Zhang, Qing; Han, Yuchi; Chen, Yucheng
• Is Part Of: European heart journal. Volume 22:Number 10(2021)
• Page Start: 1197
• Page End: 1207
• Publication Date: 2020-07-13
• Subjects: idiopathic dilated cardiomyopathy -- remodelling index -- cardiovascular magnetic resonance -- prognosis; Cardiovascular system -- Imaging -- Periodicals; Heart -- Imaging -- Periodicals; 616.10754
• DOI: 10.1093/ehjci/jeaa144
• Languages: English
• ISSNs: 2047-2404

Abstract

Abstract: Aims: To evaluate the prognostic value of left ventricular (LV) remodelling index (RI) in idiopathic dilated cardiomyopathy (DCM) patients. Methods and results: We prospectively enrolled 412 idiopathic DCM patients and 130 age- and sex-matched healthy volunteers who underwent cardiovascular magnetic resonance imaging between September 2013 and March 2018. RI was defined as the cubic root of the LV end-diastolic volume divided by the mean LV wall thickness on basal short-axis slice. The primary endpoint included all-cause mortality and heart transplantation. The secondary endpoint included the primary endpoint and heart failure (HF) readmission. During the median follow-up of 28.1 months (interquartile range: 19.3–43.0 months), 62 (15.0%) and 143 (34.7%) patients reached the primary and secondary endpoints, respectively. Stepwise multivariate Cox regression showed that RI [hazard ratio (HR) 1.20, 95% confidence interval (CI) 1.11–1.30, P < 0.001], late gadolinium enhancement (LGE) presence and log (N-terminal pro-B-type natriuretic peptide) were independent predictors of the primary endpoint, while RI (HR 1.15, 95% CI 1.08–1.23, P < 0.001) and extracellular volume were independent predictors of the secondary endpoint. The addition of RI to LV ejection fraction (EF) and LGE presence showed significantly improved global χ 2 for predicting primary and secondary endpoints (both P < 0.001). Furthermore, RI derived from echocardiography also showed independent prognostic value for primary and secondary endpoints with clinical risk factors. Conclusions: RI is an independent predictor of all-cause mortality, heart transplantation, and HF readmission in DCM patients and provides incremental prognostic value to LVEF and LGE presence.