{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:32:40Z","timestamp":1791844360932,"version":"4.3.4"},"reference-count":30,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T00:00:00Z","timestamp":1719705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cLa Caixa\u201d Foundation","award":["LCF\/BQ\/PR22\/11920008"],"award-info":[{"award-number":["LCF\/BQ\/PR22\/11920008"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Non-ischemic dilated cardiomyopathy (NIDCM) is characterized by a reduced left ventricular (LV) ejection fraction (LVEF, &lt;50%) and a high risk for heart failure (HF) and death. Echocardiography-derived hemodynamic forces (HDFs) may provide important information on LV mechanics, but their prognostic value is unknown. Aim: To explore the features of echocardiography-derived HDFs in NIDCM and their association with clinical endpoints. Methods: Asymptomatic, non-hospitalized NIDCM patients free from coronary artery disease and moderate or severe valvular heart disease were included in this single-center observational retrospective longitudinal study. Those with atrial fibrillation and a follow-up &lt;12 months were excluded. Major adverse cardiovascular events (MACE) were defined as a composite of all-cause death, HF hospitalization, and ambulatory intravenous diuretics administration. LV HDFs were analyzed with a prototype software. Apex-base (HDFs-ab), lateral-septal (HDFs-ls), and HDFs-angle were computed. Results: Ninety-seven patients were included, sixty-seven (69%) were males, mean age was 62 \u00b1 14 years, and mean LVEF was 39.2 \u00b1 8.6%. During a median follow-up of 4.2 (3.1\u20135.1) years, 19 (20%) patients experienced MACE. These patients had a higher HDFs-angle (71.0 (67.0\u201375.0) vs. 68.0 (63.0\u201371.0)\u00b0, p = 0.005), lower HDFs-ls (1.36 (1.01\u20131.85) vs. 1.66 ([1.28\u20132.04])%, p = 0.015), but similar HDFs-ab (5.02 (4.39\u20136.34) vs. 5.66 (4.53\u20136.78)%, p = 0.375) compared to those without MACE. in a Cox regression analysis, HDFs-angle (HR 1.16 (95%-CI 1.04\u20131.30), p = 0.007) was associated with MACE, while other conventional echocardiography parameters, including LVEF and LV longitudinal strain, were not. Conclusions: HDFs-angle is associated with clinical endpoints in NIDCM. A higher HDFs-angle may be a marker of impaired myocardial performance in patients with reduced LVEF.<\/jats:p>","DOI":"10.3390\/jcm13133862","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T09:06:07Z","timestamp":1719824767000},"page":"3862","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Echocardiography-Derived Hemodynamic Forces Are Associated with Clinical Outcomes in Patients with Non-Ischemic Dilated Cardiomyopathy"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5459-9942","authenticated-orcid":false,"given":"Marco","family":"Cesareo","sequence":"first","affiliation":[{"name":"Hypertension Unit, Division of Internal Medicine, University Hospital Citt\u00e0 della Salute e della Scienza of Turin, Via Genova 3, 10126 Turin, Italy"},{"name":"Department of Medical Sciences, University of Turin, Via Verdi 8, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1638-7820","authenticated-orcid":false,"given":"Eduard","family":"R\u00f3denas-Alesina","sequence":"additional","affiliation":[{"name":"Cardiology Department, Vall d\u2019Hebron University Hospital, Passeig de la Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Department of Medicine, Universitat Autonoma de Barcelona, Passeig de la Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Cardiovaculares (CIBERCV), Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Guala","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Cardiovaculares (CIBERCV), Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain"},{"name":"Vall d\u2019Hebr\u00f3n Research Institute (VHIR), Pg. de la Vall d\u2019Hebron, 119-129, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Lozano-Torres","sequence":"additional","affiliation":[{"name":"Cardiology Department, Vall d\u2019Hebron University Hospital, Passeig de la Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7122-320X","authenticated-orcid":false,"given":"Guillem","family":"Casas","sequence":"additional","affiliation":[{"name":"Cardiology Department, Vall d\u2019Hebron University Hospital, Passeig de la Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Cardiovaculares (CIBERCV), Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4628-6767","authenticated-orcid":false,"given":"Fabrizio","family":"Vallelonga","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, University of Turin, Via Verdi 8, 10124 Turin, Italy"},{"name":"Division of Internal Medicine, Candiolo Cancer Institute-Fondazione del Piemonte per l\u2019Oncologia (FPO)-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Strada Provinciale 142, KM 3.95, 10060 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Airale","sequence":"additional","affiliation":[{"name":"Hypertension Unit, Division of Internal Medicine, University Hospital Citt\u00e0 della Salute e della Scienza of Turin, Via Genova 3, 10126 Turin, Italy"},{"name":"Department of Medical Sciences, University of Turin, Via Verdi 8, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"Ferreira-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Vall d\u2019Hebron University Hospital, Passeig de la Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Department of Medicine, Universitat Autonoma de Barcelona, Passeig de la Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Consorcio de Investigaci\u00f3n Biom\u00e9dica en Red de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8863-8572","authenticated-orcid":false,"given":"Alberto","family":"Milan","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, University of Turin, Via Verdi 8, 10124 Turin, Italy"},{"name":"Division of Internal Medicine, Candiolo Cancer Institute-Fondazione del Piemonte per l\u2019Oncologia (FPO)-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Strada Provinciale 142, KM 3.95, 10060 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7229-9780","authenticated-orcid":false,"given":"Jose F.","family":"Rodriguez-Palomares","sequence":"additional","affiliation":[{"name":"Cardiology Department, Vall d\u2019Hebron University Hospital, Passeig de la Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Department of Medicine, Universitat Autonoma de Barcelona, Passeig de la Vall d\u2019Hebron 119-129, 08035 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Enfermedades Cardiovaculares (CIBERCV), Av. de Monforte de Lemos, 3-5, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1056\/NEJM199412083312307","article-title":"Idiopathic Dilated Cardiomyopathy","volume":"331","author":"Dec","year":"1994","journal-title":"N. 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Fail."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/13\/3862\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:08:18Z","timestamp":1760108898000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/13\/3862"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,30]]},"references-count":30,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["jcm13133862"],"URL":"https:\/\/doi.org\/10.3390\/jcm13133862","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,30]]}}}