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Background <p>Restrictive cardiomyopathy (RCM) is characterized by increased myocardial stiffness, impaired diastolic filling, and preserved systolic function until advanced stages. Cardiac magnetic resonance imaging (CMR) provides precise strain analysis and tissue characterization, yet its prognostic value in idiopathic RCM remains underexplored. This study aims to evaluate the prognostic significance of CMR parameters, particularly myocardial strain and late gadolinium enhancement (LGE), in predicting outcomes in patients with idiopathic RCM.</p> Results <p>Patients demonstrated moderately impaired strain values, with global longitudinal strain (GLS) measured at −10.59 ± 4.64% and global circumferential strain (GCS) at −14.50 ± 4.98%, while maintaining preserved biventricular ejection fractions. LGE was present in 40% of patients. A GLS value greater than −9.5% independently predicted mortality (odds ratio [OR]: 1.195, <i>p</i> = 0.044) and heart failure (HF) hospitalization (OR: 1.152, <i>p</i> = 0.013). Additionally, LGE emerged as a strong independent predictor of both mortality (OR: 6.340, <i>p</i> = 0.004) and HF hospitalization (OR: 4.654, <i>p</i> = 0.001).</p> Conclusions <p>CMR is a valuable tool for prognostication in idiopathic RCM. GLS and LGE are independent predictors of adverse outcomes.</p>

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Predictors of prognosis by cardiac magnetic resonance imaging in patients with idiopathic restrictive heart disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月16日

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  • Ahmed Shawky Asfour,
  • Alaa Mohamed Abd Al-Kader Mohamed,
  • Hesham Yahia Abd Al-Salam,
  • Heba Mostafa Ahmed Aboelsoud,
  • Mahmoud Shaaban,
  • Mohamed Zaki Elramly

摘要

Background

Restrictive cardiomyopathy (RCM) is characterized by increased myocardial stiffness, impaired diastolic filling, and preserved systolic function until advanced stages. Cardiac magnetic resonance imaging (CMR) provides precise strain analysis and tissue characterization, yet its prognostic value in idiopathic RCM remains underexplored. This study aims to evaluate the prognostic significance of CMR parameters, particularly myocardial strain and late gadolinium enhancement (LGE), in predicting outcomes in patients with idiopathic RCM.

Results

Patients demonstrated moderately impaired strain values, with global longitudinal strain (GLS) measured at −10.59 ± 4.64% and global circumferential strain (GCS) at −14.50 ± 4.98%, while maintaining preserved biventricular ejection fractions. LGE was present in 40% of patients. A GLS value greater than −9.5% independently predicted mortality (odds ratio [OR]: 1.195, p = 0.044) and heart failure (HF) hospitalization (OR: 1.152, p = 0.013). Additionally, LGE emerged as a strong independent predictor of both mortality (OR: 6.340, p = 0.004) and HF hospitalization (OR: 4.654, p = 0.001).

Conclusions

CMR is a valuable tool for prognostication in idiopathic RCM. GLS and LGE are independent predictors of adverse outcomes.