title: Electrocardiographic and cardiac magnetic resonance imaging parameters as predictors of a worse outcome in patients with idiopathic dilated cardiomyopathy.
abstract: OBJECTIVE
  Clinical parameters are weak predictors of outcome in patients with idiopathic dilated cardiomyopathy (IDC). We assessed the prognostic value of cardiac magnetic resonance (CMR) parameters in addition to conventional clinical and electrocardiographic characteristics.
  
  
  RESULTS
  One hundred and forty-one IDC patients were studied. QRS and QTc intervals were measured in 12-lead surface electrocardiogram. Patients were followed for median 1339 days, including 483 patient-years. The primary endpoint-cardiac death or sudden death-occurred in 25 (18%) patients, including 16 patients with cardiac death, 3 patients with sudden cardiac death (SCD), and 6 patients with ICD shock. Late gadolinium enhancement (LGE) was detected in 36 patients (26%). Kaplan-Meier survival analysis displayed QRS >110 ms (P = 0.010), the presence of LGE (P = 0.037), and diabetes mellitus (P < 0.001) as significant parameters for a worse outcome. Multivariable analysis revealed cardiac index (P < 0.001), right ventricular end-diastolic volume index (RVEDVI) (P = 0.006) derived from CMR imaging, the presence of diabetes mellitus (P = 0.006), and QRS >110 ms (P = 0.045) as significant predictors for the primary endpoint.
  
  
  CONCLUSIONS
  Cardiac index and RVEDVI derived from CMR imaging in addition to QRS duration >110 ms from conventional surface ECG and diabetes mellitus provide prognostic impact for cardiac death and SCD in patients with IDC.
authors.affiliation: Clinic of Internal Medicine II, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm 89081, Germany. vinzenz.hombach@uniklinik-ulm.de
authors.forename: Vinzenz
authors.initials: V
authors.lastname: Hombach
authors.forename: Nico
authors.initials: N
authors.lastname: Merkle
authors.forename: Jan
authors.initials: J
authors.lastname: Torzewski
authors.forename: Johann M
authors.initials: JM
authors.lastname: Kraus
authors.forename: Markus
authors.initials: M
authors.lastname: Kunze
authors.forename: Oliver
authors.initials: O
authors.lastname: Zimmermann
authors.forename: Hans A
authors.initials: HA
authors.lastname: Kestler
authors.forename: Jochen
authors.initials: J
authors.lastname: Wöhrle
mesh_terms: D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors