{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T01:43:27Z","timestamp":1772329407230,"version":"3.50.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T00:00:00Z","timestamp":1701648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate the degree of coronary microvascular dysfunction (CMD) in dilated cardiomyopathy (DCM) patients by cardiac magnetic resonance (CMR) first-pass perfusion parameters and to examine the correlation between myocardial perfusion and left ventricle reverse remodelling (LVRR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this study, 94 DCM patients and 35 healthy controls matched for age and sex were included. Myocardial perfusion parameters, including upslope, time to maximum signal intensity (Time<jats:sub>max<\/jats:sub>), maximum signal intensity (SI<jats:sub>max<\/jats:sub>), baseline signal intensity (SI<jats:sub>baseline<\/jats:sub>), and the difference between maximum and baseline signal intensity (SI<jats:sub>max\u2212baseline<\/jats:sub>) were measured. Additionally, left ventricular (LV) structure, function parameters, and late gadolinium enhancement (LGE) were also recorded. The parameters were compared between healthy controls and DCM patients. Univariable and multivariable logistic regression analyses were used to determine the predictors of LVRR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>With a median follow-up period of 12 months [interquartile range (IQR), 8\u201313], 41 DCM patients (44%) achieved LVRR. Compared with healthy controls, DCM patients presented CMD with reduced upslope, SI<jats:sub>baseline<\/jats:sub>, and increased Time<jats:sub>max<\/jats:sub> (all <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.01). Time<jats:sub>max<\/jats:sub>, SI<jats:sub>max<\/jats:sub>, and SI<jats:sub>max\u2212baseline<\/jats:sub> were further decreased in LVRR than non-LVRR group (Time<jats:sub>max<\/jats:sub>: 60.35 [IQR, 51.46\u201374.71] vs. 72.41 [IQR, 59.68\u201397.70], <jats:italic>p\u2009<\/jats:italic>=\u20090.017; SI<jats:sub>max<\/jats:sub>: 723.52 [IQR, 209.76\u2013909.27] vs. 810.92 [IQR, 581.30\u2013996.89], <jats:italic>p\u2009<\/jats:italic>=\u20090.049; SI<jats:sub>max\u2212baseline<\/jats:sub>: 462.99 [IQR, 152.25\u2013580.43] vs. 551.13 [IQR, 402.57\u2013675.36], <jats:italic>p\u2009<\/jats:italic>=\u20090.038). In the analysis of multivariate logistic regression, Time<jats:sub>max<\/jats:sub> [odds ratio (OR) 0.98; 95% confidence interval (CI) 0.95\u20131.00; <jats:italic>p\u2009<\/jats:italic>=\u20090.032)], heart rate (OR 1.04; 95% CI 1.01\u20131.08; <jats:italic>p\u2009<\/jats:italic>=\u20090.029), LV remodelling index (OR 1.73; 95% CI 1.06\u20133.00; <jats:italic>p\u2009<\/jats:italic>=\u20090.038) and LGE extent (OR 0.85; 95% CI 0.73\u20130.96; <jats:italic>p\u2009<\/jats:italic>=\u20090.021) were independent predictors of LVRR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CMD could be found in DCM patients and was more impaired in patients with non-LVRR than LVRR patients. Time<jats:sub>max<\/jats:sub> at baseline was an independent predictor of LVRR in DCM.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1301509","type":"journal-article","created":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T06:57:10Z","timestamp":1701673030000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["The predictive value of coronary microvascular dysfunction for left ventricular reverse remodelling in dilated cardiomyopathy"],"prefix":"10.3389","volume":"10","author":[{"given":"Ao","family":"Kan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinping","family":"Leng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuhao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qimin","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinwei","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengyao","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lianggeng","family":"Gong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1016\/S0140-6736(16)31713-5","article-title":"Dilated cardiomyopathy","volume":"390","author":"Weintraub","year":"2017","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1850","DOI":"10.1093\/eurheartj\/ehv727","article-title":"Proposal for a revised definition of dilated cardiomyopathy, hypokinetic non-dilated cardiomyopathy, and its implications for clinical practice: a position statement of the ESC working group on myocardial and pericardial diseases","volume":"37","author":"Pinto","year":"2016","journal-title":"Eur Heart J"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1699","DOI":"10.1016\/j.jcmg.2018.10.032","article-title":"Microvascular dysfunction in dilated cardiomyopathy: a quantitative stress perfusion cardiovascular magnetic resonance study","volume":"12","author":"Gulati","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1007\/s00392-018-1279-2","article-title":"Reduced global myocardial perfusion reserve in DCM and HCM patients assessed by CMR-based velocity-encoded coronary sinus flow measurements and first-pass perfusion imaging","volume":"107","author":"Bietenbeck","year":"2018","journal-title":"Clin Res Cardiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e5984","DOI":"10.1136\/bmjopen-2014-005984","article-title":"High reproducibility of adenosine stress cardiac MR myocardial perfusion imaging in patients with non-ischaemic dilated cardiomyopathy","volume":"4","author":"Lawson","year":"2014","journal-title":"BMJ Open"},{"key":"B6","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1016\/j.echo.2012.12.009","article-title":"Prognostic value of coronary and microvascular flow reserve in patients with nonischemic dilated cardiomyopathy","volume":"26","author":"Lima","year":"2013","journal-title":"J Am Soc Echocardiogr"},{"key":"B7","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1016\/j.cjca.2012.04.005","article-title":"Effects of allopurinol on coronary microvascular and left ventricular function in patients with idiopathic dilated cardiomyopathy","volume":"28","author":"Erdogan","year":"2012","journal-title":"Can J Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1161\/01.cir.92.4.796","article-title":"Myocardial blood flow response to pacing tachycardia and to dipyridamole infusion in patients with dilated cardiomyopathy without overt heart failure. A quantitative assessment by positron emission tomography","volume":"92","author":"Neglia","year":"1995","journal-title":"Circulation"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1016\/j.jcmg.2016.09.010","article-title":"CMR first-pass perfusion for suspected inducible myocardial ischemia","volume":"9","author":"Hendel","year":"2016","journal-title":"JACC Cardiovasc Imaging"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1016\/j.jcmg.2014.07.011","article-title":"Diagnostic accuracy of myocardial magnetic resonance perfusion to diagnose ischemic stenosis with fractional flow reserve as reference: systematic review and meta-analysis","volume":"7","author":"Li","year":"2014","journal-title":"JACC Cardiovasc Imaging"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e002666","DOI":"10.1161\/CIRCIMAGING.114.002666","article-title":"Diagnostic accuracy of stress myocardial perfusion imaging compared to invasive coronary angiography with fractional flow reserve meta-analysis","volume":"8","author":"Takx","year":"2015","journal-title":"Circ Cardiovasc Imaging"},{"key":"B12","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1161\/hc0202.102119","article-title":"Prognostic role of myocardial blood flow impairment in idiopathic left ventricular dysfunction","volume":"105","author":"Neglia","year":"2002","journal-title":"Circulation"},{"key":"B13","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.jjcc.2010.06.008","article-title":"Impact of myocardial perfusion abnormality on prognosis in patients with non-ischemic dilated cardiomyopathy","volume":"56","author":"Sobajima","year":"2010","journal-title":"J Cardiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.jacc.2012.07.072","article-title":"Novel predictors of left ventricular reverse remodeling in individuals with recent-onset dilated cardiomyopathy","volume":"61","author":"Kubanek","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1468","DOI":"10.1016\/j.jacc.2010.11.030","article-title":"Prevalence and prognostic significance of left ventricular reverse remodeling in dilated cardiomyopathy receiving tailored medical treatment","volume":"57","author":"Merlo","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1016\/j.amjcard.2010.11.033","article-title":"Effect of left ventricular reverse remodeling on long-term prognosis after therapy with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and beta blockers in patients with idiopathic dilated cardiomyopathy","volume":"107","author":"Hoshikawa","year":"2011","journal-title":"Am J Cardiol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e5220","DOI":"10.1161\/CIRCHEARTFAILURE.118.005220","article-title":"Clinical phenotype and genotype associations with improvement in left ventricular function in dilated cardiomyopathy","volume":"11","author":"Verdonschot","year":"2018","journal-title":"Circ Heart Fail"},{"key":"B18","first-page":"405","article-title":"Prevalence and clinical predictors of reverse remodeling in patients with dilated cardiomyopathy","volume":"16","author":"Arad","year":"2014","journal-title":"Isr Med Assoc J"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e7944","DOI":"10.1161\/CIRCHEARTFAILURE.120.007944","article-title":"Myocardial tissue reverse remodeling after guideline-directed medical therapy in idiopathic dilated cardiomyopathy","volume":"14","author":"Xu","year":"2021","journal-title":"Circ Heart Fail"},{"key":"B20","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1161\/CIRCIMAGING.113.000438","article-title":"Myocardial fibrosis as a key determinant of left ventricular remodeling in idiopathic dilated cardiomyopathy: a contrast-enhanced cardiovascular magnetic study","volume":"6","author":"Masci","year":"2013","journal-title":"Circ Cardiovasc Imaging"},{"key":"B21","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1001\/jama.2014.9440","article-title":"Multiple comparison procedures","volume":"312","author":"Cao","year":"2014","journal-title":"JAMA"},{"key":"B22","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1002\/ejhf.1103","article-title":"Evolving concepts in dilated cardiomyopathy","volume":"20","author":"Merlo","year":"2018","journal-title":"Eur J Heart Fail"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2614","DOI":"10.1016\/j.jacc.2009.11.011","article-title":"ACCF\/ACR\/AHA\/NASCI\/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American college of cardiology foundation task force on expert consensus documents","volume":"55","author":"Hundley","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1016\/j.jcmg.2018.07.015","article-title":"Outcome in dilated cardiomyopathy related to the extent, location, and pattern of late gadolinium enhancement","volume":"12","author":"Halliday","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"B25","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s12968-020-00610-6","article-title":"Standardized image interpretation and post-processing in cardiovascular magnetic resonance\u20142020 update: society for cardiovascular magnetic resonance (SCMR): board of trustees task force on standardized post-processing","volume":"22","author":"Schulz-Menger","year":"2020","journal-title":"J Cardiovasc Magn Reson"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e876","DOI":"10.1161\/CIR.0000000000001062","article-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure: executive summary: a report of the American college of cardiology\/American heart association joint committee on clinical practice guidelines","volume":"145","author":"Heidenreich","year":"2022","journal-title":"Circulation"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"B28","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.ijcha.2018.02.005","article-title":"Reverse remodeling in dilated cardiomyopathy: insights and future perspectives","volume":"18","author":"Merlo","year":"2018","journal-title":"Int J Cardiol Heart Vasc"},{"key":"B29","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1038\/nrcardio.2009.130","article-title":"Vascular dysfunction in idiopathic dilated cardiomyopathy","volume":"6","author":"Roura","year":"2009","journal-title":"Nat Rev Cardiol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1016\/j.carpath.2015.08.001","article-title":"The proposed new classification of coronary microcirculation as the predictor of the heart failure progression in idiopathic dilated cardiomyopathy","volume":"24","author":"Gil","year":"2015","journal-title":"Cardiovasc Pathol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00395-022-00909-8","article-title":"Coronary blood flow in heart failure: cause, consequence and bystander","volume":"117","author":"Heusch","year":"2022","journal-title":"Basic Res Cardiol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1949","DOI":"10.1007\/s10554-017-1189-9","article-title":"3.0T magnetic resonance myocardial perfusion imaging for semi-quantitative evaluation of coronary microvascular dysfunction in hypertrophic cardiomyopathy","volume":"33","author":"Yin","year":"2017","journal-title":"Int J Cardiovasc Imaging"},{"key":"B33","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1007\/s00059-018-4741-z","article-title":"Evaluation of myocardial viability in myocardial infarction patients by magnetic resonance perfusion and delayed enhancement imaging","volume":"44","author":"Sun","year":"2019","journal-title":"Herz"},{"key":"B34","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1016\/j.media.2011.12.005","article-title":"Cardiac MR perfusion image processing techniques: a survey","volume":"16","author":"Gupta","year":"2012","journal-title":"Med Image Anal"},{"key":"B35","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1002\/ejhf.2493","article-title":"Cardiac remodelling\u2014part 1: from cells and tissues to circulating biomarkers. A review from the study group on biomarkers of the heart failure association of the European society of cardiology","volume":"24","author":"Gonzalez","year":"2022","journal-title":"Eur J Heart Fail"},{"key":"B36","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1001\/jamacardio.2021.3396","article-title":"Association of myocardial blood flow reserve with adverse left ventricular remodeling in patients with aortic stenosis: the microvascular disease in aortic stenosis (MIDAS) study","volume":"7","author":"Zhou","year":"2022","journal-title":"JAMA Cardiol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1016\/j.hrthm.2014.02.014","article-title":"Cardiac resynchronization therapy restored ventricular septal myocardial perfusion and enhanced ventricular remodeling in patients with nonischemic cardiomyopathy presenting with left bundle branch block","volume":"11","author":"Ogano","year":"2014","journal-title":"Heart Rhythm"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1093\/eurheartj\/eht513","article-title":"Coronary microvascular dysfunction: an update","volume":"35","author":"Crea","year":"2014","journal-title":"Eur Heart J"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1016\/j.jacc.2008.05.064","article-title":"Depressed coronary flow reserve is associated with decreased myocardial capillary density in patients with heart failure due to idiopathic dilated cardiomyopathy","volume":"52","author":"Tsagalou","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1038\/nrcardio.2011.154","article-title":"Cardiac remodeling at the population level\u2013risk factors, screening, and outcomes","volume":"8","author":"Gjesdal","year":"2011","journal-title":"Nat Rev Cardiol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/j.ijcard.2017.10.043","article-title":"Late gadolinium enhancement as a predictor of functional recovery, need for defibrillator implantation and prognosis in non-ischemic dilated cardiomyopathy","volume":"250","author":"Barison","year":"2018","journal-title":"Int J Cardiol"},{"key":"B42","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s12968-021-00734-3","article-title":"Implications of multiple late gadolinium enhancement lesions on the frequency of left ventricular reverse remodeling and prognosis in patients with non-ischemic cardiomyopathy","volume":"23","author":"Ota","year":"2021","journal-title":"J Cardiovasc Magn Reson"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1301509\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T06:57:13Z","timestamp":1701673033000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2023.1301509\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,4]]},"references-count":42,"alternative-id":["10.3389\/fcvm.2023.1301509"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2023.1301509","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,4]]},"article-number":"1301509"}}