Non-invasive evaluation of arrhythmic risk in dilated cardiomyopathy: From imaging to electrocardiographic measures

Table 1 The main studies evaluating the association between myocardial fibrosis assessed by cardiac magnetic resonance and the risk of arrhythmic and non-arrhythmic events

Ref.	Clinical setting	Number of patients	CMR parameters	End-points(mean follow-up)	Results
Assomoul et al[26], 2006	NIDCM	101	Midwall fibrosis (LGE)	All-cause death and hospitalization (follow-up 658 ± 355 d)	Independent association with death and hospitalization
Wu et al[27], 2008	NIDCM and LVEF ≤ 35%	65	Presence and extent of LGE	Composite end-point (hospitalization for heart failure, appropriate ICD firing, cardiac death) (Follow-up median 24 mo)	Presence of LGE was associated with a greater risk of primary outcome
Iles et al[28], 2011	IDCM/NIDCM before ICD implantation	103	Regional fibrosis with LGE	Arrhythmic events and appropriate ICD therapy (follow-up 573 d)	LGE was associated with arrhythmic events and appropriate ICD therapy during follow-up
Lehrke et al[29], 2011	NIDCM	184	Presence of LGE	Composite end-point (hospitalization for decompensated heart failure, cardiac death, cardioverter defibrillator discharge) (follow-up 31 mo)	Presence of LGE was associated with composite endpoint
Gao et al[30], 2012	IDCM/NIDCM	124	Presence and quantification of LGE	Primary composite outcome: occurrence of appropriate ICD therapy, SCA, SCD (follow-up 632 ± 262 d)	Myocardial scar quantification by LGE-CMR predicts arrhythmic events in patients being evaluated for ICD eligibility
Neilan et al[31], 2013	NIDCM	162	Presence and quantification of LGE	Major adverse cardiac events (cardiovascular death and appropriate ICD therapy) (follow-up: 29 ± 18 mo)	Presence of LGE was a strong predictor of major cardiac events
Li et al[32], 2013	NIDCM	293	Presence and extent of LGE	All-cause mortality (follow-up: 3.2 yr)	Presence of LGE is an independent predictor of increased all-cause mortality Diffuse LGE is associated with higher mortality
Gulati et al[33], 2013	NIDCM	472	Presence and extent of midwall fibrosis	Primary end-point: all cause mortality Secondary end-point: cardiovascular mortality or cardiac transplantation Arrhythmic and HF secondary end-points (follow-up 5.3 yr)	Midwall fibrosis assessed with LGE-CMR provided independent prognostic information and improved risk stratification beyond LVEF for all-cause mortality and SCD

CMR: Cardiac magnetic resonance; IDCM: Ischemic dilated cardiomyopathy; LGE: Late gadolinium enhancement; NIDCM: Non ischemic dilated cardiomyopathy; SCA Survived cardiac arrest; SCD: Sudden cardiac death; ICD: Implantable cardioverter defibrillator.