Myocardial Extracellular Matrix Volume has independent prognostic value in patients with non-ischemic cardiomyopathy

Background Left ventricular ejection fraction (LVEF) is the most validated independent prognostic factor for mortality, ventricular arrhythmias and heart failure (HF) in non-ischemic dilated cardiomyopathy without etiology. However, mild or moderate reduction LVEF yield limited predictive value. The amount of fibrosis, detected by late gadolinium enhancement (LGE) on CMR, has also been validated as an independent predictor factor. Conventional imaging techniques cannot robustly quantify the full spectrum of extracellular cardiac matrix volume (ECV) expansion. ECV expansion often may not be evident on LGE CMR or other modalities. Quantifying ECV may ultimately provide independent prognostic value to improve care through targeted treatment. The aim of this study was to determine the prognostic value of myocardial ECV expansion in patients with nonischemic cardiomyopathy.