The extracellular volume fraction (ECV) by T1 mapping can quantify diffuse myocardial fibrosis, and useful as a non-invasive marker for risk stratification for patients with non-ischemic dilated cardiomyopathy (NIDCM). Prolonged QRS interval on electrocardiogram is related to worse clinical outcome for heart failure patients. The purpose of this study was to evaluate the prognostic value of the combination of ECV and QRS duration for NIDCM patients. A total of 60 NIDCM patients (mean age 61 ± 12 years, mean left ventricular ejection fraction 37 ± 10%, mean QRS duration 110 ± 19 ms) were enrolled. Using a 1.5-T MR scanner and 32-channel cardiac coils, the mean ECV value of six myocardial segments at the mid-ventricular level was measured by the modified look-locker inversion recovery method. Adverse events were defined as follows: cardiac death; recurrent hospitalization due to heart failure. Patients were allocated into three groups based on ECV value and QRS duration (group 1: ECV ≦ 0.30 and QRS ≦ 120 ms; group 2: ECV > 0.30 or QRS > 120 ms; group 3: ECV > 0.30 and QRS > 120 ms). During a median follow-up duration of 370 days, 7 of 60 (12%) NIDCM patients experienced adverse events. NIDCM patients with events had longer QRS duration (134 ± 31 ms vs. 106 ± 14 ms, p = 0.01) and higher ECV (0.34 ± 0.07 vs 0.29 ± 0.05, p = 0.026) compared with those without events. On Kaplan-Meier curve analysis, significant difference was found between group 1 and group 3 (p < 0.001, log-rank test). No significant difference was found between group 1 and group 2 (p = 0.053), group 2 and group 3 (p = 0.115). The area under the receiver operating characteristic curve (AUC) for predicting adverse events was 0.778 (95% confidence interval CI 0.612-0.939) for ECV, 0.792 (95% CI 0.539-0.924) for QRS duration, 0.822 (95% CI 0.688-0.966) for combination of ECV and QRS duration. NIDCM patients with high ECV and prolonged QRS duration had significantly worse prognosis compared to those with normal ECV and normal QRS duration. The combination of ECV and QRS duration could be useful as a non-invasive method for better risk stratification for patients with NIDCM.

中文翻译：

---

非缺血性扩张型心肌病患者通过心脏磁共振成像结合细胞外体积分数和QRS持续时间进行危险分层。

通过T1作图的细胞外体积分数（ECV）可以量化弥漫性心肌纤维化，并可用作非缺血性扩张型心肌病（NIDCM）患者危险分层的非侵入性标志物。心电图上QRS间隔的延长与心力衰竭患者的临床预后差有关。这项研究的目的是评估ECV和QRS持续时间联合治疗对NIDCM患者的预后价值。共入选60例NIDCM患者（平均年龄61±12岁，平均左心室射血分数37±10％，平均QRS持续时间110±19 ms）。使用1.5-T MR扫描仪和32通道心脏线圈，通过改良的外观锁定器反转恢复方法测量心室中层水平的六个心肌节段的平均ECV值。不良事件定义如下：心源性死亡；因心力衰竭而再次住院。根据ECV值和QRS持续时间将患者分为三组（第1组：ECV≤0.30和QRS≤120 ms；第2组：ECV> 0.30或QRS> 120 ms；第3组：ECV> 0.30和QRS> 120 ms） 。在370天的中位随访期间，60名NIDCM患者中有7名（12％）发生了不良事件。与无事件的患者相比，有事件的NIDCM患者的QRS持续时间更长（134±31 ms vs. 106±14 ms，p = 0.01），ECV较高（0.34±0.07 vs 0.29±0.05，p = 0.026）。在Kaplan-Meier曲线分析中，第1组和第3组之间存在显着差异（p <0.001，对数秩检验）。组1和组2（p = 0.053），组2和组3（p = 0.115）之间没有发现显着差异。用于预测不良事件的接收器工作特征曲线（AUC）下的面积对于ECV为0.778（95％置信区间CI 0.612-0.939），对于QRS持续时间为0.792（95％CI 0.539-0.924），0.822（95％CI 0.688- 0.966），以结合ECV和QRS持续时间。与正常ECV和QRS持续时间正常的患者相比，ECV高且QRS持续时间较长的NIDCM患者的预后明显更差。ECV和QRS持续时间的结合可用作NIDCM患者更好的危险分层的非侵入性方法。与正常ECV和QRS持续时间正常的患者相比，ECV高且QRS持续时间较长的NIDCM患者的预后明显更差。ECV和QRS持续时间的结合可用作NIDCM患者更好的危险分层的非侵入性方法。与具有正常ECV和正常QRS持续时间的患者相比，具有高ECV和QRS持续时间延长的NIDCM患者的预后明显更差。ECV和QRS持续时间的结合可用作NIDCM患者更好的危险分层的非侵入性方法。