Current Insights and Novel Cardiovascular Magnetic Resonance-Based Techniques in the Prognosis of Non-Ischemic Dilated Cardiomyopathy

Abstract

Cardiac magnetic resonance (CMR) imaging has an important emerging role in the evaluation and management of patients with cardiomyopathies, especially in patients with dilated cardiomyopathy (DCM). It allows a non-invasive characterization of myocardial tissue, thus assisting early diagnosis and precise phenotyping of the different cardiomyopathies, which is an essential step for early and individualized treatment of patients. Using imaging techniques such as late gadolinium enhancement (LGE), standard and advanced quantification as well as quantitative mapping parameters, CMR-based tissue characterization is useful in the differential diagnosis of DCM and risk stratification. The purpose of this article is to review the utility of CMR in the diagnosis and management of idiopathic DCM, as well as risk prediction and prognosis based on standard and emerging CMR contrast and non-contrast techniques. This is consistent with current evidence and guidance moving beyond traditional prognostic markers such as ejection fraction.

Advances in dilated cardiomyopathy evaluation via cardiac MRI diagnosis and prognosis: a literature review

“…An indexed left ventricular end-diastolic volume (LVEDVi) on CMR > 120.5 mL/m2 and the presence of more than three segments with midwall fibrosis are independent predictors of all causes of death (Guaricci et al, 2021). Because of direct right ventricular involvement, Juillière et al found that right ventricular ejection fraction (RVEF) is a minor predictor of hospitalisation for heart failure (HF) in patients with DCM and an independent predictor of all-cause mortality (Perone et al, 2024). The left atrial volume index (LAVi), a sensitive indicator of LV filling pressure and a significant predictor of transplant-free survival and heart failure risk, is another parameter that might be assessed by CMR (Perone et al, 2024).…”