Temporal change of myocardial tissue character is associated with left ventricular reverse remodeling in patients with dilated cardiomyopathy: A cardiovascular magnetic resonance study

Abstract Background Prognostic significance of temporal change in myocardial tissue characterization by cardiovascular magnetic resonance (CMR) has not been elucidated in patients with non-ischemic dilated cardiomyopathy (DCM). Methods and results Sixty-eight patients with newly-diagnosed DCM who underwent CMR including late gadolinium enhancement (LGE) both at baseline and during follow-up period were enrolled. LGE score was defined by a signal intensity of ≥5 standard deviations above the remote reference myocardium mean. Left ventricular reverse remodeling (LVRR) defined as a LV ejection fraction increase of ≥10% and a decrease in indexed LV end-diastolic diameter of ≥10% compared to those at baseline was detected in 38% of the patients. There was no significant difference in LGE score between baseline and follow-up (5.8% vs. 7.3%; p = 0.38). The change in LGE area (delta-LGE) was significantly lower in patients with LVRR than those without (−0.5% ± 3.4% vs. 3.0 ± 7.4%; p = 0.02). On the other hand, T2 ratio during the follow-up significantly reduced (1.95 ± 0.48 vs. 1.67 ± 0.56; p < 0.01); however, there was no significant difference in the change in T2 ratio between patients with LVRR and those without (−0.29 ± 0.73 vs. −0.27 ± 0.66; p = 0.88). Multivariate logistic analysis indicated that baseline LGE score [odds ratio; 0.78; 95% confidence interval (CI) 0.66 to 0.90; p < 0.01] together with delta-LGE (odds ratio; 0.77; 95% CI 0.61 to 0.92; p = 0.01) were independently associated with subsequent LVRR ( p < 0.01). Conclusions The temporal change of LGE-CMR score during the clinical course was significantly correlated with following LVRR.