{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:31:47Z","timestamp":1787808707503,"version":"build-2784847793"},"reference-count":35,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2016,10,5]]},"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging has been reported to be associated with unfavourable outcomes; however, few studies have addressed the prognostic value of left ventricular (LV) deformation parameter indicated by global longitudinal strain (GLS) in two-dimensional speckle-tracking (2DST) echocardiography in patients with non-ischaemic dilated cardiomyopathy (DCM). This study aims to investigate whether the combination of GLS and LGE is useful in stratifying the risk in patients with DCM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We studied 179 consecutive symptomatic patients with DCM (age, 61\u00b115\u2005years; 121 males; left ventricular ejection fraction (LVEF) 33%\u00b19%; New York Heart Association (NYHA) class II: n=71, III: n=107, IV: n=1) who underwent CMR and echocardiography with conventional assessment and 2DST analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 40 rehospitalisations for heart failure, including 7 cardiac deaths and 2 implantations of LV assist device during follow-up (3.8\u00b12.5\u2005years). Univariable Cox proportional hazard regression analysis showed that NYHA class, blood pressure, B-type natriuretic peptide, LV end-diastolic and end-systolic volumes, LVEF, left atrium volume, GLS and LGE were significantly associated with long-term outcome. Multivariable analysis revealed that GLS and LGE were independently associated with long-term outcome (p&lt;0.05, both). In additional analyses, we found independent associations between GLS and LV reverse remodelling after the optimal medical therapy, and between LGE and life-threatening arrhythmias (p&lt;0.05, both).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Combining GLS and LGE could be useful for risk stratification and prognostic assessment in patients with DCM.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/heartjnl-2016-309746","type":"journal-article","created":{"date-parts":[[2016,10,31]],"date-time":"2016-10-31T21:48:46Z","timestamp":1477950526000},"page":"679-686","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":60,"title":["Longitudinal strain combined with delayed-enhancement magnetic resonance improves risk stratification in patients with dilated cardiomyopathy"],"prefix":"10.1136","volume":"103","author":[{"given":"Misato","family":"Chimura","sequence":"first","affiliation":[{"name":"Himeji Cardiovascular Center, Himeji, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuari","family":"Onishi","sequence":"additional","affiliation":[{"name":"Himeji Cardiovascular Center, Himeji, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasue","family":"Tsukishiro","sequence":"additional","affiliation":[{"name":"Himeji Cardiovascular Center, Himeji, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Sawada","sequence":"additional","affiliation":[{"name":"Himeji Cardiovascular Center, Himeji, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiko","family":"Kiuchi","sequence":"additional","affiliation":[{"name":"Himeji Cardiovascular Center, Himeji, 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