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].