Cardiac magnetic resonance
In the era of multi-modality imaging, despite the progresses made in innovative echocardiographic techniques, CMR remains the gold standard for the assessment of RV volumes and EF [75, 76]. Several studies have evaluated the prognostic role of CMR-derived RVEF in patients with reduced LVEF. In a prospective study enrolling 250 patients with DCM, Gulati et al. found that RVEF is an independent predictor for transplant-free survival, improving risk stratification for patients with DCM [77]. Mikami et al. showed that in patients with LV systolic dysfunction, RVEF<45% is a strong independent predictor of arrhythmic events (sudden cardiac arrest or appropriate implantable cardioverter defibrillator therapy) [78]. In a recent study, Pueschner et al. prospectively evaluated a cohort of patients with non-ischaemic DCM during a median follow-up time of 6.2 years and found that RVEF was a strong independent predictor of cardiac death [79]. All-cause mortality in patients with DCM was independently predicted by RVEF in another study [80]. Interesting results were found by Gill et al., who compared the prognostic role of RVEF in patients with ischaemic and non-ischaemic cardiomyopathy, who were followed for all-cause death and for a composite endpoint of death, acute coronary syndrome, stroke, admission for HF and defibrillator implantation. RVEF proved to be an independent predictor of all-cause death and of MACE in patients with non-ischaemic cardiomyopathy, but not in patients with ischaemic cardiomyopathy [81].