title: Novel predictors of left ventricular reverse remodeling in individuals with recent-onset dilated cardiomyopathy.
abstract: OBJECTIVE
  This study aimed to evaluate the performance of cardiac magnetic resonance (CMR), cardiac biomarkers, and endomyocardial biopsy (EMB) results to predict left ventricular reverse remodeling (LVRR) in individuals with recent-onset dilated cardiomyopathy (DCM).
  
  
  BACKGROUND
  LVRR is a marker of a favorable prognosis in individuals with recent-onset DCM. We used the aforementioned novel methods of prognostication to predict this event.
  
  
  METHODS
  A total of 44 consecutive patients with recent-onset DCM underwent at baseline CMR, measurement of biomarkers and EMB together with conventional methods, including cardiopulmonary exercise testing and echocardiography. Measurement of B-type natriuretic peptide (BNP) and the cardiological examination were repeated at 3, 6, and 12 months. CMR was repeated at 12 months. LVRR was defined as an absolute increase in left ventricular ejection fraction from ≥10% to a final value of >35% accompanied by a decrease in left ventricular end-diastolic dimension ≥10% at 12 months of follow-up.
  
  
  RESULTS
  LVRR was observed in 20 individuals (45%) at 12 months. At baseline, a lower extent of late gadolinium enhancement (odds ratio [OR]: 0.67 [95% confidence interval (CI): 0.50 to 0.90]; p = 0.008) and a higher myocardial edema ratio (OR: 1.45 [95% CI: 1.04 to 2.02]; p = 0.027) measured by CMR were independent predictors of LVRR. At 3 months, the latest BNP plasma level (OR: 0.14 [95% CI: 0.02 to 0.94] per log BNP; p = 0.047) was the strongest predictor of LVRR.
  
  
  CONCLUSIONS
  Both CMR and serial BNP testing provide a better prediction of LVRR in recent-onset DCM than EMB results, other biomarkers, and the conventional methods of follow-up.
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. milos.kubanek@ikem.cz
authors.forename: Milos
authors.initials: M
authors.lastname: Kubanek
authors.forename: Marek
authors.initials: M
authors.lastname: Sramko
authors.forename: Jana
authors.initials: J
authors.lastname: Maluskova
authors.forename: Dana
authors.initials: D
authors.lastname: Kautznerova
authors.forename: Jiri
authors.initials: J
authors.lastname: Weichet
authors.forename: Petr
authors.initials: P
authors.lastname: Lupinek
authors.forename: Jana
authors.initials: J
authors.lastname: Vrbska
authors.forename: Ivan
authors.initials: I
authors.lastname: Malek
authors.forename: Josef
authors.initials: J
authors.lastname: Kautzner
mesh_terms: D000328:Adult; D015415:Biomarkers; D001706:Biopsy; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D003287:Contrast Media / Q000008:administration & dosage; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D004487:Edema / Q000473:pathology; D004699:Endocardium / Q000473:pathology; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009205:Myocarditis / Q000453:epidemiology; D009206:Myocardium / Q000473:pathology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009942:Organometallic Compounds / Q000008:administration & dosage; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D009942:Organometallic Compounds; D020097:Natriuretic Peptide, Brain; C090600:gadobutrol