{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:17:40Z","timestamp":1793330260925,"version":"4.5.0"},"reference-count":143,"publisher":"American Medical Association (AMA)","issue":"18","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2024,11,12]]},"abstract":"\n Importance<\/jats:title>\n Accurate risk stratification of nonischemic dilated cardiomyopathy (NIDCM) remains challenging.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the association of cardiac magnetic resonance (CMR) imaging\u2013derived measurements with clinical outcomes in NIDCM.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n MEDLINE, Embase, Cochrane Library, and Web of Science Core Collection databases were systematically searched for articles from January 2005 to April 2023.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n Prospective and retrospective nonrandomized diagnostic studies reporting on the association between CMR imaging\u2013derived measurements and adverse clinical outcomes in NIDCM were deemed eligible.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n Prespecified items related to patient population, CMR imaging measurements, and clinical outcomes were extracted at the study level by 2 independent reviewers. Random-effects models were fitted using restricted maximum likelihood estimation and the method of Hartung, Knapp, Sidik, and Jonkman.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n All-cause mortality, cardiovascular mortality, arrhythmic events, heart failure events, and major adverse cardiac events (MACE).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 103 studies including 29\u202f687 patients with NIDCM were analyzed. Late gadolinium enhancement (LGE) presence and extent (per 1%) were associated with higher all-cause mortality (hazard ratio [HR], 1.81 [95% CI, 1.60-2.04];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001 and HR, 1.07 [95% CI, 1.02-1.12];\n P<\/jats:italic>\n \u2009=\u2009.02, respectively), cardiovascular mortality (HR, 2.43 [95% CI, 2.13-2.78];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001 and HR, 1.15 [95% CI, 1.07-1.24];\n P<\/jats:italic>\n \u2009=\u2009.01), arrhythmic events (HR, 2.69 [95% CI, 2.20-3.30];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001 and HR, 1.07 [95% CI, 1.03-1.12];\n P<\/jats:italic>\n \u2009=\u2009.004) and heart failure events (HR, 1.98 [95% CI, 1.73-2.27];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001 and HR, 1.06 [95% CI, 1.01-1.10];\n P<\/jats:italic>\n \u2009=\u2009.02). Left ventricular ejection fraction (LVEF) (per 1%) was not associated with all-cause mortality (HR, 0.99 [95% CI, 0.97-1.02];\n P<\/jats:italic>\n \u2009=\u2009.47), cardiovascular mortality (HR, 0.97 [95% CI, 0.94-1.00];\n P<\/jats:italic>\n \u2009=\u2009.05), or arrhythmic outcomes (HR, 0.99 [95% CI, 0.97-1.01];\n P<\/jats:italic>\n \u2009=\u2009.34). Lower risks for heart failure events (HR, 0.97 [95% CI, 0.95-0.98];\n P<\/jats:italic>\n \u2009=\u2009.002) and MACE (HR, 0.98 [95% CI, 0.96-0.99];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) were observed with higher LVEF. Higher native T1 relaxation times (per 10 ms) were associated with arrhythmic events (HR, 1.07 [95% CI, 1.01-1.14];\n P<\/jats:italic>\n \u2009=\u2009.04) and MACE (HR, 1.06 [95% CI, 1.01-1.11];\n P<\/jats:italic>\n \u2009=\u2009.03). Global longitudinal strain (GLS) (per 1%) was not associated with heart failure events (HR, 1.06 [95% CI, 0.95-1.18];\n P<\/jats:italic>\n \u2009=\u2009.15) or MACE (HR, 1.03 [95% CI, 0.94-1.14];\n P<\/jats:italic>\n \u2009=\u2009.43). Limited data precluded definitive analysis for native T1 relaxation times, GLS, and extracellular volume fraction (ECV) with respect to mortality outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The presence and extent of LGE were associated with various adverse clinical outcomes, whereas LVEF was not significantly associated with mortality and arrhythmic end points in NIDCM. Risk stratification using native T1 relaxation times, extracellular volume fraction, and global longitudinal strain requires further evaluation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2024.13946","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T12:06:59Z","timestamp":1726747619000},"page":"1535","source":"Crossref","is-referenced-by-count":61,"title":["Risk Stratification in Nonischemic Dilated Cardiomyopathy Using CMR Imaging"],"prefix":"10.1001","volume":"332","author":[{"given":"Christian","family":"Eichhorn","sequence":"first","affiliation":[{"name":"Division of Acute Medicine, University Hospital Basel, Basel, Switzerland"},{"name":"Private University in the Principality of Liechtenstein, Triesen"},{"name":"Department of Internal Medicine, See-Spital, Horgen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Koeckerling","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohin K.","family":"Reddy","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London, United Kingdom"},{"name":"Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddalena","family":"Ardissino","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London, United Kingdom"},{"name":"Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom"},{"name":"British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Rogowski","sequence":"additional","affiliation":[{"name":"Private University in the Principality of Liechtenstein, Triesen"},{"name":"Agaplesion General Hospital, Hagen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadette","family":"Coles","sequence":"additional","affiliation":[{"name":"Velindre University NHS Trust Library & Knowledge Service, Cardiff University, Cardiff, Wales"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Hunziker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Greulich","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Shiri","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Eckstein","sequence":"additional","affiliation":[{"name":"Division of Acute Medicine, University Hospital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Windecker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond Y.","family":"Kwong","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George C. 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