- Poster presentation
- Open Access
Predicting mortality in patients with non-ischemic dilative cardiomyopathy: Potential of extracellular volume imaging by cardiovascular magnetic resonance
© Koopmann et al.; licensee BioMed Central Ltd. 2014
- Published: 16 January 2014
- Cardiovascular Magnetic Resonance
- Dilate Cardiomyopathy
- Myocardial Injury
- Extracellular Volume
Predicting mortality in patients with non-ischemic dilated cardiomyopathy (NIDCM) is currently demanding and requires complex models. Assessing the extracellular volume fraction (ECV) by T1-mapping cardiovascular magnetic resonance (CMR) is an attractive approach to quantify myocardial injury as a potential predictor of adverse events in these patients. This study evaluated ECV imaging by T1-mapping CMR in comparison with the established "Seattle Heart Failure Model" (SHFM; http://www.seattleheartfailuremodel.org).
This study included 50 patients with heart failure and reduced left ventricular (LV) ejection fraction due to non-ischemic cardiomyopathy. The SHFM was used to estimate 1, 2 and 5 year mortalities as well as life expectancy, respectively. T1 quantification was performed at 1.5 Tesla using the modified Look-Locker inversion-recovery (MOLLI) sequence on 3 short-axes before and 15 minutes after administration of 0.075 mmol/kg gadolinium-BOPTA. Global myocardial ECV was then calculated from native and post-contrast T1 maps generated by a dedicated plug-in written for the OsiriX software, respectively.
Median predicted 1-, 2- and 5-year mortalities were 4% (interquartile range 2-6%), 7% (interquartile range 5-12%) and 16% (interquartile range 12-28%) in the study population, respectively. Median estimated life expectancy was 13 years (interquartile range 9-15 years). A significant correlation was found between global myocardial ECV and predicted 1- (r = 0.47; p < 0.001), 2- (r = 0.46; p < 0.001) and 5-year mortality (r = 0.46; p < 0.001), respectively. Furthermore, a significant inverse correlation was found between global myocardial ECV and predicted life expectancy (r = -0.37; p < 0.01).
Myocardial injury as quantified by ECV-imaging correlates well with predicted mortality and has great potential to improve risk stratification in patients with heart failure due to NIDCM.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.