Evaluation of cardiac MRI findings and their association with clinical characteristics and outcomes in patients with dilated cardiomyopathy and left ventricular systolic dysfunction:  A prospective observational study.

Dr.Puppala Sirisha  Naidu; Dr. Bharat  Kakileti; Dr. Roja  Dwarampudi; Dr. Anand  Acharya

doi:10.51168/sjhrafrica.v6i12.2353

Authors

Dr. Puppala Sirisha Naidu Assistant Professor, Department of Radiology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India
Dr. Bharat Kakileti Associate Professor, Department of Radiology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India
Dr. Roja Dwarampudi Assistant Professor, Department of Radiology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India
Dr. Anand Acharya Dean and Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2353

Keywords:

Dilated cardiomyopathy, Cardiac magnetic resonance imaging, Late gadolinium enhancement, Myocardial fibrosis, Left ventricular systolic dysfunction, Prognosis

Abstract

Background:
Dilated cardiomyopathy (DCM) is a major cause of chronic heart failure and is characterized by left ventricular (LV) dilatation with impaired systolic function. Prognosis in DCM varies widely and depends on underlying myocardial pathology.

Aim:

To evaluate cardiac MRI findings and analyze their association with clinical characteristics and outcomes in patients with dilated cardiomyopathy and left ventricular systolic dysfunction.

Materials and Methods:

This prospective observational study included 100 patients diagnosed with DCM and LV systolic dysfunction. All participants underwent CMR using a standardized imaging protocol. Left and right ventricular volumes, LV ejection fraction (LVEF), and the presence and pattern of LGE were assessed. Clinical data and outcomes, including heart failure–related hospitalizations, ventricular arrhythmias, and all-cause mortality, were recorded during follow-up. Associations between CMR parameters, clinical variables, and outcomes were analyzed using appropriate statistical methods.

Results:

The mean age of patients was 52.6 ± 11.4 years, with a male predominance (68%). LGE suggestive of myocardial fibrosis was detected in 62% of patients, most commonly showing a mid-wall pattern. Patients with LGE demonstrated significantly lower LVEF compared to those without LGE (27.4 ± 5.8% vs. 33.5 ± 6.1%; p < 0.001). Adverse clinical outcomes, including recurrent heart failure hospitalization, ventricular arrhythmias, and mortality, were more frequent among LGE-positive patients.

Conclusion:

Cardiac MRI provides comprehensive diagnostic and prognostic information in dilated cardiomyopathy. The presence of myocardial fibrosis on LGE is strongly associated with poorer LV function and unfavorable clinical outcomes, highlighting its role in risk stratification.

Recommendations:

Routine incorporation of cardiac MRI with LGE assessment is recommended in patients with DCM for early risk stratification. Patients with LGE may benefit from closer follow-up, aggressive heart failure management, and timely consideration of device therapy to improve clinical outcomes.

Author Biographies

Dr. Puppala Sirisha Naidu, Assistant Professor, Department of Radiology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India

is an Assistant Professor in the Department of Radiology at Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India. Her academic interests include cardiovascular imaging, cross-sectional imaging, and advanced MRI applications. She is actively involved in undergraduate and postgraduate teaching and has contributed to clinical research focused on the diagnostic and prognostic role of imaging modalities.

Dr. Bharat Kakileti, Associate Professor, Department of Radiology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India

is an Associate Professor in the Department of Radiology at Konaseema Institute of Medical Sciences, Amalapuram. He has extensive experience in diagnostic radiology with special expertise in cardiac MRI and body imaging. His academic work includes mentoring postgraduate students and participating in institutional research projects aimed at improving imaging-based clinical decision-making.

Dr. Roja Dwarampudi, Assistant Professor, Department of Radiology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India

is an Assistant Professor in the Department of Radiology at Konaseema Institute of Medical Sciences, Amalapuram. Her professional interests encompass diagnostic radiology, MRI interpretation, and radiological correlation with clinical outcomes. She is engaged in teaching, clinical service, and collaborative research activities within the department.

Dr. Anand Acharya, Dean and Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India

MBBS, MD (Pharmacology), currently serves as Dean and Professor, Department of Pharmacology, at the Konaseema Institute of Medical Sciences & Research Foundation (KIMS&RF), Amalapuram, Andhra Pradesh, India. A distinguished academician, researcher, and medical education leader, he has been pivotal in transforming KIMS&RF from its formative phase into a premier medical institution with over 200 undergraduate and 100 postgraduate seats.

With more than 18 years of teaching and administrative experience, Dr. Acharya has held several leadership positions, including Vice Principal, Principal, Chief Warden, Member Secretary of Institutional Ethics and Animal Ethics Committees, and is an approved PhD Guide under Dr. NTR University of Health Sciences, Vijayawada. His visionary leadership has significantly enhanced the institution’s academic quality, clinical exposure, research infrastructure, and postgraduate training standards.

He has completed prestigious national faculty development programs such as the Revised Basic Course Workshop (rBCW), Advanced Course in Medical Education (ACME), and National Teacher Training Course (NTTC, JIPMER, Puducherry). He also serves as Coordinator for Pharmacovigilance and Materiovigilance Programs under IPC–PvPI and MoHFW, Government of India, contributing actively to national drug safety and regulatory initiatives.

A prolific academician, Dr. Acharya has authored and co-authored more than 100 scientific publications in reputed national and international indexed journals. His wide-ranging research covers toxicology, pharmacovigilance, antimicrobial resistance, endocrinology, neuropharmacology, and clinical pharmacology. His recent studies include long-term analyses of pyrethroid, paraquat, and chlorpyrifos poisoning, investigations into antimicrobial resistance trends, and predictive models for treatment outcomes in dermatological and toxicological emergencies.

Dr. Acharya’s professional interests include clinical pharmacology, toxicovigilance, rational drug use, pharmacovigilance systems, and innovations in medical education technologies. He continues to mentor numerous postgraduate and undergraduate researchers while playing an integral role in curriculum reform, ethics governance, and institutional academic advancement.ORCID iD: https://orcid.org/0009-0000-7967-9092

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