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Contrast-enhanced T1 mapping-based extracellular volume fraction independently predicts clinical outcome in patients with non-ischemic dilated cardiomyopathy: a prospective cohort study

 Jong-Chan Youn  ;  Yoo Jin Hong  ;  Hye-Jeong Lee  ;  Kyunghwa Han  ;  Chi Young Shim  ;  Geu-Ru Hong  ;  Young Joo Suh  ;  Jin Hur  ;  Young Jin Kim  ;  Byoung Wook Choi  ;  Seok-Min Kang 
 European Radiology, Vol.27(9) : 3924-3933, 2017 
Journal Title
 European Radiology 
Issue Date
Cardiomyopathy, Dilated/mortality ; Cardiomyopathy, Dilated/pathology* ; Contrast Media ; Female ; Gadolinium ; Heart/physiopathology ; Heart Failure/etiology ; Heart Failure/mortality ; Heart Failure/pathology ; Humans ; Magnetic Resonance Angiography/methods ; Male ; Middle Aged ; Myocardium/pathology ; Patient Readmission/statistics & numerical data ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Ventricular Dysfunction, Left/mortality ; Ventricular Dysfunction, Left/pathology
Extracellular space ; Magnetic resonance imaging ; Myocardium ; Prognosis ; T1 mapping
OBJECTIVES: We aimed to evaluate the prognostic role of cardiac magnetic resonance imaging (CMR)-based extracellular volume fraction (ECV) in patients with non-ischemic dilated cardiomyopathy (NIDCM) and compare it with late gadolinium enhancement (LGE) parameters. METHODS: This was a single-center, prospective, cohort study of 117 NIDCM patients (71 men, 51.9 ± 16.7 years) who underwent clinical 3.0-T CMR. Myocardial ECV and LGE were quantified on the left ventricular myocardium. The presence of midwall LGE was also detected. Nineteen healthy subjects served as controls. The primary end points were cardiovascular (CV) events defined by CV death, rehospitalization due to heart failure, and heart transplantation. RESULTS: During the follow-up period (median duration, 11.2 months; 25th-75th percentile, 7.8-21.9 months), the primary end points occurred in 19 patients (16.2%). The ECV (per 3% and 1% increase) was associated with a hazard ratio of 1.80 and 1.22 (95% confidence interval [CI], 1.48-2.20 and 1.14-1.30, respectively; p < 0.001) for the CV events. Multivariable analysis also indicated that ECV was an independent prognostic factor and had a higher prognostic value (Harrell's c statistic, 0.88) than LGE quantification values (0.77) or midwall LGE (0.80). CONCLUSION: CMR-based ECV independently predicts the clinical outcome in NIDCM patients. KEY POINTS: • T1-mapping-based ECV is a useful parameter of risk stratification in NIDCM • ECV has a higher prognostic value than LGE • Contrast-enhanced T1-mapping CMR is a feasible and safe method.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
강석민(Kang, Seok Min) ORCID logo https://orcid.org/0000-0001-9856-9227
김영진(Kim, Young Jin) ORCID logo https://orcid.org/0000-0002-6235-6550
서영주(Suh, Young Joo) ORCID logo https://orcid.org/0000-0002-2078-5832
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
윤종찬(Youn, Jong Chan)
이혜정(Lee, Hye Jeong) ORCID logo https://orcid.org/0000-0003-4349-9174
최병욱(Choi, Byoung Wook) ORCID logo https://orcid.org/0000-0002-8873-5444
허진(Hur, Jin) ORCID logo https://orcid.org/0000-0002-8651-6571
홍그루(Hong, Geu Ru) ORCID logo https://orcid.org/0000-0003-4981-3304
홍유진(Hong, Yoo Jin) ORCID logo https://orcid.org/0000-0002-7276-0944
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