The comparison of short-term prognostic value of T1 mapping with feature tracking by cardiovascular magnetic resonance in patients with severe dilated cardiomyopathy

To evaluate and compare the prognostic value of T1 mapping with feature tracking cardiovascular magnetic resonance (FT-CMR) imaging in patients with severe dilated cardiomyopathy (DCM) during short-term follow-up. A total of 46 patients with severe DCM (LVEF < 35%) underwent 3.0-T CMR with T1 mapping and FT-CMR analysis. The study end-point was defined as a combination of cardiac death, heart transplantation, and hospitalization due to cardiovascular events. The significance of the risk factors was mainly evaluated by univariate and multivariate Cox model analyses. During the median follow-up of 13 months (interquartile range 7–17 months), two patients died of heart failure, one received a heart transplantation, and six were hospitalized for heart failure. In the univariate analysis, extracellular volume fraction (ECV) showed significant predictive association with cardiovascular events (hazard ratio [HR] 1.35; 95% confidence interval [CI] 1.13–1.62; P = 0.001). No strain parameters in FT-CMR differed significantly between patients with or without events (all P > 0.05). In the multivariate analyses, ECV was the sole independent predictor of cardiovascular events (HR, 1.48; 95% CI 1.13–1.94; P = 0.005). The area under the curve of the time-dependent receiver operating characteristic in leave-one-out cross-validation (all > 0.70) further confirmed the predictive significance of ECV. In patients with severe DCM, ECV was not only a strong independent predictor of adverse cardiovascular events but also provided prognostic value prior to strain parameters of the FT-CMR in the short term.