Background Peak oxygen consumption (peak VO2) and late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) are prognostic in heart failure. We investigated whether LGE-CMR and peak VO2 combined had additive value in risk stratifying patients with nonischemic dilated cardiomyopathy (DCM).
Methods and Results Fifty-seven DCM patients underwent CMR and cardiopulmonary exercise testing. Cardiac events were cardiac death, hospitalization for decompensated heart failure, or lethal arrhythmia. Twenty-five (44%) were LGE-positive. The median peak VO2 was 18.5 mL·kg-1·min-1. On multivariate analysis, positive LGE (P =.048) and peak VO2 (P =.003) were independent cardiac event predictors. Cardiac event risk was significantly higher with positive LGE and peak VO2 < 18.5 mL·kg-1·min-1 than with negative LGE and peak VO2 ≥ 18.5 mL·kg-1·min-1 (hazard ratio 12.5; 95% CI 1.57-100; P =.017). In 3 patient groups (group A: no LGE, peak VO2 ≥ 18.5 mL·kg-1·min-1, n = 18; group B: positive LGE or peak VO2 < 18.5 mL·kg-1·min-1, n = 24; group C: positive LGE and peak VO2 < 18.5 mL·kg-1·min-1, n = 15) during follow-up (71 ± 32 months), group C had higher cardiac event rates than the others.
Conclusions Combined assessment of LGE-CMR and peak VO2 provides additive prognostic information in ambulatory DCM.
All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine