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Prognostic value of left ventricular remodelling index in idiopathic dilated cardiomyopathy

Yuanwei Xu1, Jiayi Lin1, Yaodan Liang1,2

  • 1Department of Cardiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan 610041, China.

European Heart Journal. Cardiovascular Imaging
|July 14, 2020
PubMed

Insights

The left ventricular remodelling index (RI) is a significant predictor of mortality and heart failure readmission in dilated cardiomyopathy (DCM) patients. This index offers valuable prognostic information beyond traditional measures like ejection fraction.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Heart Failure Research

Background:

  • Idiopathic dilated cardiomyopathy (DCM) poses significant risks for mortality and heart failure (HF).
  • Accurate prognostic markers are crucial for managing DCM patients.
  • Left ventricular (LV) remodelling is a key feature in DCM progression.

Purpose of the Study:

  • To assess the prognostic capability of the LV remodelling index (RI) in patients with idiopathic DCM.
  • To determine if RI improves risk stratification when combined with established markers.

Main Methods:

  • Prospective enrollment of 412 DCM patients and 130 healthy controls.
  • Cardiovascular magnetic resonance imaging (CMR) to calculate RI (cbrt(LV end-diastolic volume)/mean LV wall thickness).
  • Follow-up for primary (all-cause mortality, heart transplantation) and secondary (primary endpoints + HF readmission) endpoints.

Main Results:

  • RI independently predicted the primary endpoint (HR 1.20) and secondary endpoint (HR 1.15).
  • RI, along with late gadolinium enhancement (LGE) and N-terminal pro-B-type natriuretic peptide, predicted mortality/transplantation.
  • RI improved prediction models that included LV ejection fraction (LVEF) and LGE.
  • Echocardiography-derived RI also demonstrated prognostic value.

Conclusions:

  • The LV remodelling index (RI) is an independent predictor of adverse outcomes in DCM.
  • RI provides incremental prognostic value beyond LVEF and LGE presence.
  • RI is a valuable tool for risk stratification in DCM patients.
Abstract

Keywords:
cardiovascular magnetic resonanceidiopathic dilated cardiomyopathyprognosisremodelling index

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