SPC365

Risk Stratification in Nonischemic Dilated Cardiomyopathy: The Role of T1/T2 Mapping and Extracellular Volume

Session: SESSÃO DE POSTERS 48 - RESSINCRONIZAÇÃO CARDÍACA E CDI
Speaker: Inês Amorim Cruz

Congress: CPC 2025
Topic: D. Heart Failure
Theme: 10. Chronic Heart Failure
Subtheme: 10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type: Cartazes
FP Number: ---
Authors: Inês Amorim Cruz; Simão Carvalho; Carlos Costa; Tiago Aguiar; Ana Catarina Faustino; Luís Miguel Santos; Ana Briosa

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><em><u><span style="font-size:10.5pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Background:</span></span></u></em> <span style="font-size:10.5pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Nonischemic dilated cardiomyopathy (NIDCM) is an increasingly recognized cause of cardiovascular morbidity and mortality. Despite this, accurate risk stratification of NIDCM remains challenging. Recent studies showed that the presence and extent of late gadolinium enhancement (LGE) are associated with adverse clinical outcomes. However, the prognostic value of T1, T2 mapping and extracellular volume (ECV) is less explored.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><em><u><span style="font-size:10.5pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Aim:</span></span></u></em><span style="font-size:10.5pt"><span style="font-family:&quot;Times New Roman&quot;,serif"> To explore the predictive value of cardiovascular magnetic resonance (CMR) findings - T1, T2 mapping and ECV - for heart failure (HF)-related events in NIDCM patients.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><em><u><span style="font-size:10.5pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Methods:</span></span></u></em><span style="font-size:10.5pt"><span style="font-family:&quot;Times New Roman&quot;,serif"> Between February 2022 and October 2024, patients diagnosed with NIDCM who underwent CMR at our center were included. All CMR images were acquired using a 1.5-T scanner (Magnetom Sola, Siemens Healthcare, Erlangen, Germany). T1 mapping was quantified within the septal myocardium in areas without LGE enhancement (T1 native) and ECV was calculated using pre, post-contrast T1 and </span></span><span style="font-size:10.5pt"><span style="font-family:&quot;Times New Roman&quot;,serif">synthetic </span></span><span style="font-size:10.5pt"><span style="font-family:&quot;Times New Roman&quot;,serif">haematocrit. The primary endpoint was HF hospitalization.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><em><u><span style="font-size:10.5pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Results:</span></span></u></em><span style="font-size:10.5pt"><span style="font-family:&quot;Times New Roman&quot;,serif"> Among the 53 patients with NIDCM, 40% were women, with a median age of 64 years [IQR 52-69], 55% were in NYHA 2 or higher, 15% had an implantable device and the median LV ejection fraction was 40% [IQR 30-47]. During a median follow-up of 13 months [IQR 5-22], only 6 patients (11%) had a HF hospitalization. Apart from the NT-proBNP value (3578&nbsp;[IQR 3203-3959], p=0.008), these patients were similar compared with patients with no HF hospitalization. T1 mapping and ECV was similar between NYHA class (p=0.21 and p=0.33, respectively) and both were correlated with LV ejection fraction (r =&nbsp;-0.46, p=&lt;0.001 and r = -0.44, p=0.001, respectively). In univariable Cox regression analysis, although T1 mapping (HR=1.01, [95% CI, 0.99-1.02], p=0.3) and T2 mapping (HR=1.01, [95% CI, 0.83-1.23], p=&gt;0.9) were not associated with higher risk of HF hospitalization, patients with higher ECV had higher risk of HF hospitalization (HR=1.11, [95% CI, 1.01-1.22], p=0.03, Table 1). In multivariable Cox regression analysis, including age, gender and LV ejection fraction, ECV remain an independent predictor of HF hospitalization (HR=1.13, [95% CI, 1.00-1.28], p=0.046, Table 1).</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><em><u><span style="font-size:10.5pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Conclusion:</span></span></u></em><span style="font-size:10.5pt"><span style="font-family:&quot;Times New Roman&quot;,serif"> In this cohort of patients diagnosed with NIDCM, extracellular volume&nbsp;was an independent predictor of HF hospitalization, suggesting its usefulness as a potential non-invasive marker for risk stratification in these patients.</span></span></span></span></span></p>