Predictive Value For Mortality Of Ventricular Wall Thickness Measured By CMR In Dilated Cardiomyopathy

Background:Ventricular remodeling is an essential pathological feature of dilated cardiomyopathy(DCM)and impacts on its prognosis.However,the research of this aspect is not sufficient.Aims:The purpose of this study was to explore the predictive value of wall thickness measured by cardiac magnetic resonance(CMR)for all-cause mortality in DCM patients.Methods:DCM patients who underwent CMR and completed the regular follow-up were included in this study.The left ventricular end-diastolic diameter(LVDd),left ventricular posterior wall thickness(PWth),interventricular septum wall thickness(IVSth),and left ventricular ejection fraction(LVEF)were measured by CMR.The relative posterior wall thickness(RWTPW)and relative interventricular septum wall thickness(RWTIVS)were defined by the following equations:RWTPW=(2×PWth)/LVDd and RWTIVS=(2×IVSth)/LVDd.All patients received regular telephone and outpatient follow-up.The primary endpoint was all-cause mortality.Results:A total of 161 patients were enrolled in this study,including 126(78.3%)males.The mean age was 52.28±13.59 years.During the median follow-up of 47 months(interquartile range(IQR)32-57 months),41(24.8%)patients died.Compared with the non-death group,LVDd(75.21±11.94mm vs 70.53±8.76mm;P=0.025)was greater in the death group,while PWth(5.2mm[3.7-6.8]vs 6.9mm[5.3-8.55];P<0.001),IVSth(8.2mm[6.5-9.5]vs 9.3mm[7.4-10.5];P=0.005),RWTPW(0.15[0.11-0.19]vs 0.20[0.15-0.25];P<0.001)and RWTIVS(0.22[0.17-0.26]vs 0.26[0.22-0.31];P<0.001)were lower.Multivariate COX regression analysis showed that PWth[hazard ratio(HR)0.778,95%confidence interval(CI)0.648-0.934,P<0.05]and RWTPW(HR 0.000,95%CI 0.000-0.101,P<0.05)were independent predictors of all-cause death.In contrast,IVSth and RWTIVS were not clearly associated with death.RWTPW has a larger area under the ROC curve compared to PWth.Conclusions:Posterior wall thickness measured by CMR is an independent predictor of all-cause mortality in DCM patients.However,there was no significant correlation between septum wall thickness and mortality.