SPC365

Dilated cardiomyopathy: does the right ventricle have an impact on prognostic outcomes?

Session: Sessão de Posters 48 - Risco arrítmico, tomada de decisão e desfechos nas miocardiopatias
Speaker: Andreia Lopes Sousa

Congress: CPC 2026
Topic: F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme: 17. Myocardial Disease
Subtheme: 17.2 Myocardial Disease – Epidemiology, Prognosis, Outcome
Session Type: Posters Eletrónicos
FP Number: ---
Authors: Andreia Lopes Sousa; Mónica Dias; Sabrina Diniz Padrão; Sofia Fernandes; Carla Ferreira; Filipe Vilela; Bárbara Rocha; João Faria; Rui Flores; Vítor Hugo Pereira; Carla Marques Pires

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">Introduction: </span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">Dilated cardiomyopathy (DCM) is characterized by ventricular dilatation and systolic dysfunction in the absence of abnormal loading conditions or significant coronary artery disease and remains an important cause of heart failure and cardiac death. Although left ventricular (LV) impairment is classically emphasized, right ventricular (RV) structure and function may have important prognostic implications in DCM.</span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">Aim</span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">: To assess the impact of the right ventricle on clinical outcomes in DCM patients.</span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">Methods:&nbsp;</span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">We performed a retrospective, observational, single-center study including patients with DCM who underwent cardiac magnetic resonance (CMR) between 2019 and 2025. Patients were followed for a median of 37 months. RV and LV volumes, mass and ejection fraction (EF) were quantified by CMR. The primary composite endpoint (all-cause mortality, heart failure hospitalization, or ventricular arrhythmia) was analysed.</span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">Results and discussion: </span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">A total of 153 patients were included, 66% male, with a mean age of 62.5 &plusmn; 13.8 years.</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif"> In our study population, 64.7% had idiopathic DCM. Only 26% (<em>n</em>=40) underwent genetic testing, of which 17,5% had a pathogenic or likely pathogenic variant. </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">Right and left ventricular ejection fractions were positively correlated, with moderate strength (</span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">&rho; </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">= 0,533, <em>p</em> &lt; 0,001). A significant difference was found in median RV ejection fraction between patients who did and did not reach the composite outcome (50% vs. 57,5%, <em>p</em> &lt; 0,002). RV end-diastolic volume alone was not associated with the composite outcome.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">In the multivariable logistic regression model including LVEF and RVEF, only RVEF remained significantly associated with the primary composite endpoint (<em>p</em>=0.025, odds ratio 0.95; 95% confidence interval 0.91&ndash;0.99), whereas LVEF was not significant. Thus, lower RVEF is associated with higher risk, with the odds of an adverse outcome increasing by roughly 5% for every 1% decrease in RVEF.&nbsp;</span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">Conclusion: </span></span></strong><span style="font-size:11.0pt"><span style="font-family:&quot;News Gothic MT&quot;,sans-serif">In this cohort, RVEF assessed by CMR emerged as an independent predictor of adverse outcomes beyond conventional and more frequent parameters such as LVEF. Routine RV assessment may improve risk stratification and guide follow-up and therapeutic decisions in patients with DCM.</span></span></span></span></p>