Clinical Characteristics, Cardiac Magnetic Resonance Features, and Outcomes of Patients with Dilated Cardiomyopathy - An Experience from a South Asian Country

Objectives: The objectives of the study were to evaluate the clinical presentation, cardiac magnetic resonance (CMR) features, and outcomes of patients with dilated cardiomyopathy (DCM). Material and Methods: A retrospective study was conducted at a tertiary care center of Pakistan. All patients who underwent CMR for further evaluation of DCM during the period of 2011-2019 and in whom CMR confirmed the diagnosis of DCM, were included in the study. Patients were followed up in the year 2020 for all-cause mortality and cardiovascular hospitalizations. Results: A total of 75 patients were included in the study. The mean age was 38.7 +/- 13 with the majority (n = 57, 76%) being male. Dyspnea was the most common presenting symptom (n = 68, 90.7%). The mean left ventricle ejection fraction (LVEF) by CMR was 29.3 +/- 12 and mean left ventricle stroke volume (LVSV) was 665 +/- 31. Late gadolinium enhanced (LGE) was present in 28 (37.3%) patients. Follow-up was available in 61 patients with the mean follow-up duration of 39.7 +/- 27 months. Most patients (40, 65.6%) experienced all-cause major adverse cardiovascular events (MACE) during the follow-up and mortality was observed in 10 (16.4%) patients. LVSV by CMR (P = 0.03), LVEF by CMR (P = 0.02), and presence of pericardial effusion (PE) (P = 0.01) were significantly associated with all-cause MACE. On multiregression analysis, SV by CMR was associated with all cause MACE (P = 0.048). The presence of LGE was associated with higher mortality (P = 0.03). Conclusion: LVSV, LVEF by CMR, and PE were significantly associated with all-cause MACE. LGE was associated with higher mortality. Our cohort had a relatively younger age of presentation and diagnosis, and a greater mortality on follow-up, when compared with other regions of the world.