Cardiac magnetic resonance imaging to predict left ventricular reverse remodelling in non-ischaemic dilated cardiomyopathy: a systematic review and meta-analysis.

AIM

This systematic review and meta-analysis aimed to evaluate the predictive value of cardiac magnetic resonance (CMR) imaging parameters for left ventricular reverse remodelling (LVRR) in patients with nonischaemic dilated cardiomyopathy (DCM).

MATERIALS AND METHODS

Electronic databases were searched for studies examining late gadolinium enhancement (LGE), native T1, and extracellular volume (ECV). A random-effect meta-analysis was conducted, with heterogeneity assessed using the I statistic.

RESULTS

Seventeen studies involving 1,465 participants (mean age: 54.3 years; LGE prevalence: 31%-69%) were included, with an average follow-up of 18.6 months. LGE was a strong univariate predictor of LVRR (pooled odds ratio [OR]: 3.65; 95% confidence interval [CI]: 2.45 to 5.45). A meta-analysis of three studies showed that LGE remained predictive after adjustment for baseline characteristics (pooled adjusted OR: 2.84; 95% CI: 1.50-5.37). Patients without LVRR had a greater LGE extent (weighted mean difference [MD]: 4.19%; 95% CI: 2.40%-5.97%), longer native T1 times (weighted MD: 44.84 ms; 95% CI: 25.92-63.76 ms), and higher ECV (weighted MD: 4.33%; 95% CI: 2.40%-6.26%).

CONCLUSION

The absence of LGE is a robust predictor of LVRR, even after adjustment for baseline characteristics. Patients with LVRR demonstrated lower LGE extent, shorter T1 times, and lower ECV, underscoring the utility of these CMR markers as indicators of myocardial recovery. Future research should focus on incorporating CMR parameters into clinical decision-making algorithms to enhance the management and outcomes of patients with DCM.