Impact of morphological differences in gadolinium late enhancement on prognosis in dilated cardiomyopathy and their association with electrocardiographic characteristics
He Ting
You Qin
Qu Xuanzhong
Liu Wei
He Xin
Abstract：Objective To investigate the prognostic impact of morphological differences in cardiac magnetic reso-nance(CMR)-derived late gadolinium enhancement(LGE)patterns and their associations with electrocardiographic(ECG)characteristics in patients with non-ischemic dilated cardiomyopathy(NIDCM).Methods A prospective cohort study was conducted involving 387 NIDCM patients who underwent CMR at the Department of Cardiology,Liuyang People's Hospital Affiliated to University of South China,between January 2022 and June 2024.Based on CMR LGE morphology,patients were divided into a linear enhancement pattern group(n=255)and a patchy enhancement pattern group(n=132).Kaplan-Meier analysis was used to compare 12-month survival.Multivariate Cox and Logistic regression analyses were performed to identify predictors of all-cause mortality and patchy LGE,respectively.Results The proportions of inverted T waves in inferior leads,inverted T waves in anterolateral leads,and first-degree atrioventricular block were significantly higher in the patchy pattern group compared to the linear pattern group(x2/P=22.016/＜0.001,13.595/＜0.001,14.448/＜0.001,respectively).At the 12-month follow-up,the survival rate was higher in the linear pattern group(Log-Rank x2=17.381,P＜0.001).Multivariate Cox regression showed that a patchy enhancement pattern was an independent risk factor for all-cause mortality[HR(95％CI)=4.011(1.952-8.243)].Multivariate logistic regression revealed that inverted T waves in inferior leads,inverted T waves in anterolateral leads,and first-degree atrioventricular block were independent risk factors for the presence of a patchy LGE pattern[OR(95％CI)=2.936(1.496-5.880),2.095(1.301-3.370),5.034(1.816-16.258),respectively].Conclusion Morphological characteristics of CMR LGE in NIDCM patients show significant prognostic differences.Patients with a patchy enhancement pattern have a higher risk of death.ECG characteristics,specifically inverted T waves in inferior and anterolateral leads and first-degree atrioventricular block,are significantly associated with a patchy LGE pattern,providing new insights for risk stratification.
Keywords：Non-ischemic dilated cardiomyopathyCardiac magnetic resonanceLate gadolinium enhancementPrognosisElectrocardiogram
Publication Date：2025-09-18
Online Publishing Date：2025-10-11(First online date of this platform, not the publication date of the document)
Pages：5( 1031-1035 )