Extract

Background: Myocardial fibrosis has an impact on poor prognosis in patients with nonischemic dilated cardiomyopathy (NIDCM). The Selvester QRS score using twelve-lead electrocardiogram (ECG) has been reported to be associated with both amount of myocardial scar and poor prognosis in patients with myocardial infarction. However, little is known about its availability in patients with NIDCM.

Purpose: The purpose of this study was to investigate the prognostic value of the Selvester QRS score and the association with collagen volume fraction (CVF) in patients with NIDCM.

Methods: We enrolled 93 consecutive NIDCM patients (68 males, 53±13 years). Patients with permanent pacemaker or cardiac resynchronization therapy device were excluded. All patients were hospitalized in our institute for examination under each individual stable condition of heart failure (HF) and underwent twelve-lead ECG, echocardiography, right heart catheterization and endomyocardial biopsy. The CVF of biopsy specimen was measured by two observers in a blinded manner. The patients were divided into two groups based on the median value of the Selvester QRS score as follows; low score group (LS group, ≤3 points) (n=49) and high score group (HS group, >3 points) (n=44). Cardiac events were defined as a composite of cardiac death, hospitalization for worsening HF, and lethal arrhythmia. All patients were followed up for a mean of 4.4 years.

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