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<p>Dilated cardiomyopathy (DCM) is one of the most common forms of non-ischemic cardiomyopathy, characterized by dilation and systolic dysfunction of the left ventricle. The disease is associated with a high risk of adverse outcomes, including decompensation of chronic heart failure (CHF) and sudden cardiac death (SCD). Traditionally, the identification of candidates for implantable cardioverter-defibrillators (ICDs) for primary prevention of SCD has relied on the left ventricular ejection fraction (LVEF ≤ 35%). However, with advances in medical therapy for CHF, cardiac resynchronization therapy, modern cardiac imaging techniques such as magnetic resonance imaging (MRI) with delayed enhancement, and genetic research, there is a need to revise the approaches to SCD risk stratification. This review addresses the current state of the art in risk stratification for SCD in patients with DCM. Special attention is given to the role of MRI imaging techniques, which significantly expand risk assessment capabilities and allow for more precise identification of patients who require ICD implantation for primary SCD prevention.</p>

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MRI-based Approach to Sudden Cardiac Death Risk Stratification in Dilated Cardiomyopathy: A State of the Art Review

  • 期刊论文

  • 发表日期：

    2026年2月7日

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  • Bektur Sh. Berdibekov,
  • Svetlana A. Alexandrova,
  • Naida I. Bulaeva,
  • Elena Z. Golukhova

摘要

Dilated cardiomyopathy (DCM) is one of the most common forms of non-ischemic cardiomyopathy, characterized by dilation and systolic dysfunction of the left ventricle. The disease is associated with a high risk of adverse outcomes, including decompensation of chronic heart failure (CHF) and sudden cardiac death (SCD). Traditionally, the identification of candidates for implantable cardioverter-defibrillators (ICDs) for primary prevention of SCD has relied on the left ventricular ejection fraction (LVEF ≤ 35%). However, with advances in medical therapy for CHF, cardiac resynchronization therapy, modern cardiac imaging techniques such as magnetic resonance imaging (MRI) with delayed enhancement, and genetic research, there is a need to revise the approaches to SCD risk stratification. This review addresses the current state of the art in risk stratification for SCD in patients with DCM. Special attention is given to the role of MRI imaging techniques, which significantly expand risk assessment capabilities and allow for more precise identification of patients who require ICD implantation for primary SCD prevention.