{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:58:10Z","timestamp":1792814290232,"version":"4.5.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T00:00:00Z","timestamp":1658707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Alliance Medical and UHSM Fellowship Salary"},{"name":"UHSM CMR study","award":["NCT02326324"],"award-info":[{"award-number":["NCT02326324"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate whether cardiac magnetic resonance (CMR)-based parametric mapping and strain analysis can improve the risk-stratification for ventricular arrhythmias (VA) and sudden death (SD) in non-ischaemic cardiomyopathy (NICM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Secondary analysis of a prospective single-centre-registry (NCT02326324), including 703 consecutive NICM patients, 618 with extracellular volume (ECV) available. The combined primary endpoint included appropriate implantable cardioverter defibrillator therapies, sustained ventricular tachycardia, resuscitated cardiac arrest and SD. During a median follow-up of 21 months, 14 patients (2%) experienced the primary endpoint. Native T1 was not associated with the primary endpoint. Left ventricular global longitudinal strain lost its significant association after adjustment for left ventricular ejection fraction (LVEF). Among patients with ECV available, 11 (2%) reached the primary endpoint. Mean ECV was significantly associated with the primary endpoint and the best cut-off was 30%. ECV \u2265 30% was the strongest independent predictor of the primary endpoint (hazard ratio 14.1, P = 0.01) after adjustment for late gadolinium enhancement (LGE) and LVEF. ECV \u2265 30% discriminated the arrhythmic risk among LGE+ cases and among those with LVEF \u2264 35%. A simple clinical risk-stratification model, based on LGE, LVEF \u2264 35% and ECV \u2265 30%, achieved an excellent predictive ability (Harrell\u2019s C 0.82) and reclassified the risk of 32% of the study population as compared to LVEF \u2264 35% alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Comprehensive CMR evaluation in NICM showed that ECV was the only parameter with an independent and strong predictive value for VA\/SD, on top of LGE and LVEF. A risk-stratification model based on LGE, LVEF \u2264 35% and ECV \u2265 30% achieved an excellent predictive ability for VA\/SD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>UHSM CMR study (NCT02326324) https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02326324.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjci\/jeac142","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T11:19:18Z","timestamp":1658747958000},"page":"512-521","source":"Crossref","is-referenced-by-count":31,"title":["Extracellular volume fraction improves risk-stratification for ventricular arrhythmias and sudden death in non-ischaemic cardiomyopathy"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8322-8112","authenticated-orcid":false,"given":"Andrea","family":"Di Marco","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital Universitari de Bellvitge , Calle feixa llarga s\/n, 08907 L\u2019Hospitalet de Llobregat, Barcelona 08907 , Spain"},{"name":"Bioheart-Cardiovascular Diseases Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge\u2013IDIBELL, L\u2019Hospitalet de Llobregat , Barcelona 08907 , Spain"},{"name":"Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre , Manchester M13 9PL , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela F","family":"Brown","sequence":"additional","affiliation":[{"name":"Manchester University Foundation Trust-Wythenshawe Site , Southmoor Road, Wythenshawe, Manchester M239LT , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Bradley","sequence":"additional","affiliation":[{"name":"Manchester University Foundation Trust-Wythenshawe Site , Southmoor Road, Wythenshawe, Manchester M239LT , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Nucifora","sequence":"additional","affiliation":[{"name":"Manchester University Foundation Trust-Wythenshawe Site , Southmoor Road, Wythenshawe, Manchester M239LT , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignasi","family":"Anguera","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitari de Bellvitge , Calle feixa llarga s\/n, 08907 L\u2019Hospitalet de Llobregat, Barcelona 08907 , Spain"},{"name":"Bioheart-Cardiovascular Diseases Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge\u2013IDIBELL, L\u2019Hospitalet de Llobregat , Barcelona 08907 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher A","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre , Manchester M13 9PL , UK"},{"name":"Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester M13 9NQ , UK"},{"name":"Wellcome Centre for Cell-Matrix Research, Division of Cell-Matrix Biology & Regenerative Medicine, School of Biology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre , Manchester M13 9PL , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Schmitt","sequence":"additional","affiliation":[{"name":"Manchester University Foundation Trust-Wythenshawe Site , Southmoor Road, Wythenshawe, Manchester M239LT , UK"},{"name":"Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester M13 9NQ , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,25]]},"reference":[{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1056\/NEJMoa1608029","article-title":"Defibrillator implantation in patients with nonischemic systolic heart failure","volume":"375","author":"K\u00f8ber","year":"2016","journal-title":"N Engl J Med"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jchf.2016.09.017","article-title":"Late Gadolinium enhancement and the risk for ventricular arrhythmias or sudden death in dilated cardiomyopathy: systematic review and meta-analysis","volume":"5","author":"Di Marco","year":"2017","journal-title":"JACC Heart Fail"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"2890","DOI":"10.1016\/j.jacc.2021.04.030","article-title":"Improved risk stratification for ventricular arrhythmias and sudden death in patients with nonischemic dilated cardiomyopathy","volume":"77","author":"Di Marco","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.jcmg.2015.12.001","article-title":"T1-mapping and outcome in nonischemic cardiomyopathy: all-cause mortality and heart failure","volume":"9","author":"Puntmann","year":"2016","journal-title":"JACC Cardiovasc Imaging"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"3924","DOI":"10.1007\/s00330-017-4817-9","article-title":"Contrast-enhanced T1 mapping-based extracellular volume fraction independently predicts clinical outcome in patients with non-ischemic dilated cardiomyopathy: a prospective cohort study","volume":"27","author":"Youn","year":"2017","journal-title":"Eur Radiol"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.ijcard.2020.04.052","article-title":"Prognostic value of cardiovascular magnetic resonance T1 mapping techniques in non-ischemic dilated cardiomyopathy: a systematic review and meta-analysis","volume":"312","author":"Kiaos","year":"2020","journal-title":"Int J Cardiol"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1016\/j.jcmg.2018.08.021","article-title":"Comparing CMR mapping methods and myocardial patterns toward heart failure outcomes in nonischemic dilated cardiomyopathy","volume":"12","author":"Vita","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1016\/j.jcmg.2017.10.024","article-title":"Feature-tracking global longitudinal strain predicts death in a multicenter population of patients with ischemic and nonischemic dilated cardiomyopathy incremental to ejection fraction and Late Gadolinium enhancement","volume":"11","author":"Romano","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1080\/10976640600572889","article-title":"Normalized left ventricular systolic and diastolic function by steady state free precession cardiovascular magnetic resonance","volume":"8","author":"Maceira","year":"2006","journal-title":"J Cardiovasc Magn Reson"},{"key":"2023032123092539400_","article-title":"ASNC\/AHA\/ASE\/EANM\/HFSA\/ISA\/SCMR\/SNMMI expert consensus recommendations for multimodality imaging in cardiac amyloidosis: part 2 of 2-diagnostic criteria and appropriate utilization","volume":"14","author":"Dorbala","year":"2021","journal-title":"Circ Cardiovasc Imaging"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1093\/ehjci\/jex146","article-title":"A joint procedural position statement on imaging in cardiac sarcoidosis: from the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine, the European Association of Cardiovascular Imaging, and the American Society of Nuclear Cardiology","volume":"18","author":"Slart","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1161\/hc0402.102975","article-title":"Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart","volume":"105","author":"Cerqueira","year":"2002","journal-title":"Circulation"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1161\/CIRCIMAGING.112.000192","article-title":"Comprehensive validation of cardiovascular magnetic resonance techniques for the assessment of myocardial extracellular volume","volume":"6","author":"Miller","year":"2013","journal-title":"Circ Cardiovasc Imaging"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/1532-429X-15-35","article-title":"Standardized image interpretation and post processing in cardiovascular magnetic resonance","volume":"1","author":"Schulz-Menger","year":"2013","journal-title":"J Cardiovasc Magn Reson"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1002\/jmri.23892","article-title":"Quantification of left ventricular indices from SSFP cine imaging: impact of real-world variability in analysis methodology and utility of geometric modeling","volume":"37","author":"Miller","year":"2013","journal-title":"J Magn Reson Imaging"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1148\/radiol.2018180226","article-title":"Native T1 and extracellular volume measurements by cardiac MRI in healthy adults: a meta-analysis","volume":"290","author":"Gottbrecht","year":"2019","journal-title":"Radiology"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"2106","DOI":"10.1016\/j.hrthm.2015.05.026","article-title":"Myocardial scar predicts monomorphic ventricular tachycardia but not polymorphic ventricular tachycardia or ventricular fibrillation in nonischemic dilated cardiomyopathy","volume":"12","author":"Piers","year":"2015","journal-title":"Heart Rhythm"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1016\/j.jacep.2020.10.002","article-title":"Myocardial substrate characterization by CMR T1 mapping in patients with NICM and no LGE undergoing catheter ablation of VT","volume":"7","author":"Muser","year":"2021","journal-title":"JACC Clin Electrophysiol"},{"key":"2023032123092539400_","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal - Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/24\/4\/512\/49576724\/jeac142.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/24\/4\/512\/49576724\/jeac142.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T18:11:59Z","timestamp":1700849519000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article\/24\/4\/512\/6649615"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,25]]},"references-count":19,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,7,25]]},"published-print":{"date-parts":[[2023,3,21]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjci\/jeac142","relation":{},"ISSN":["2047-2404","2047-2412"],"issn-type":[{"value":"2047-2404","type":"print"},{"value":"2047-2412","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,4,1]]},"published":{"date-parts":[[2022,7,25]]}}}