Cardiac Magnetic Resonance Imaging for Risk Stratification in Nonischemic Cardiomyopathy

Late gadolinium enhancement — but not left ventricular ejection fraction — predicts death and arrhythmic risk.

Nonischemic dilated cardiomyopathy (NIDCM) is associated with substantial morbidity and mortality, partly due to elevated risks for malignant ventricular arrhythmias. Based upon relatively dated randomized trial results, implantable cardioverter-defibrillators (ICDs) are typically indicated when patients have severe left-ventricular systolic dysfunction or left-ventricular ejection fraction (LVEF) below 35%. More recently, the availability of cardiac magnetic resonance imaging (CMRI) has expanded, and the importance of CMRI findings such as late gadolinium enhancement (LGE) for prognostication in patients with NIDCM has been recognized, presenting an opportunity to reevaluate the traditional approach to risk stratification.

Researchers aggre…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, MACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)