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

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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; 25 th –75 th 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.

Original languageEnglish
Pages (from-to)3924-3933
Number of pages10
JournalEuropean Radiology
Volume27
Issue number9
DOIs
Publication statusPublished - 2017 Sep 1

Fingerprint

Gadolinium
Dilated Cardiomyopathy
Cohort Studies
Prospective Studies
Magnetic Resonance Imaging
Heart Transplantation
Myocardium
Healthy Volunteers
Heart Failure
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Youn, Jong Chan ; Hong, Yoo Jin ; Lee, Hye Jeong ; Han, Kyunghwa ; Shim, Chi Young ; Hong, Geu Ru ; Suh, Young Joo ; Hur, Jin ; Kim, Young Jin ; Choi, Byoung Wook ; Kang, Seok Min. / Contrast-enhanced T1 mapping-based extracellular volume fraction independently predicts clinical outcome in patients with non-ischemic dilated cardiomyopathy : a prospective cohort study. In: European Radiology. 2017 ; Vol. 27, No. 9. pp. 3924-3933.
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title = "Contrast-enhanced T1 mapping-based extracellular volume fraction independently predicts clinical outcome in patients with non-ischemic dilated cardiomyopathy: a prospective cohort study",
abstract = "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; 25 th –75 th 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.",
author = "Youn, {Jong Chan} and Hong, {Yoo Jin} and Lee, {Hye Jeong} and Kyunghwa Han and Shim, {Chi Young} and Hong, {Geu Ru} and Suh, {Young Joo} and Jin Hur and Kim, {Young Jin} and Choi, {Byoung Wook} and Kang, {Seok Min}",
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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. / Youn, Jong Chan; Hong, Yoo Jin; Lee, Hye Jeong; Han, Kyunghwa; Shim, Chi Young; Hong, Geu Ru; Suh, Young Joo; Hur, Jin; Kim, Young Jin; Choi, Byoung Wook; Kang, Seok Min.

In: European Radiology, Vol. 27, No. 9, 01.09.2017, p. 3924-3933.

Research output: Contribution to journalArticle

TY - JOUR

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

T2 - a prospective cohort study

AU - Youn, Jong Chan

AU - Hong, Yoo Jin

AU - Lee, Hye Jeong

AU - Han, Kyunghwa

AU - Shim, Chi Young

AU - Hong, Geu Ru

AU - Suh, Young Joo

AU - Hur, Jin

AU - Kim, Young Jin

AU - Choi, Byoung Wook

AU - Kang, Seok Min

PY - 2017/9/1

Y1 - 2017/9/1

N2 - 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; 25 th –75 th 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.

AB - 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; 25 th –75 th 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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