Late gadolinium enhancement as a predictor of functional recovery, need for defibrillator implantation and prognosis in non-ischemic dilated cardiomyopathy

Aim of the study was to investigate whether late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) predict reverse remodeling (RR) in non-ischemic dilated cardiomyopathy (NIDCM). Seventy-one NIDCM patients (age 57±14years, 43 males, median left ventricular ejection fraction [LVEF] 35%, [interquartile range 27–41%]) with two CMR scans within 5years were included. RR was defined as ≥10% reduction in left ventricular (LV) end-diastolic volume and ≥10% LVEF increase. The end-point was a composite of all-cause death, cardiovascular hospitalization or appropriate defibrillator discharge. LGE was assessed both visually and as percentage of LV mass (LGE%). LGE was present in 42 patients (59%). During the interval between the 2 CMR scans (median 28 [15–44]months), 22 patients (31%) displayed RR. LGE absence predicted RR irrespectively of baseline LV volumes and LVEF. Over a median 42[15–73]-month follow-up, the endpoint occurred in 36 patients (51%). LGE absence was associated with better prognosis (P=0.043), with best quantitative LGE cut-point