ISSN 2996-8215
International Journal of Cardiology | Vol. 17, No. 8, August 2026 | pp. 1–8
DOI: 10.46882/2026/IJC/100001
Original Article
Title: Myocardial Fibrosis and Ventricular Arrhythmias in Non-Ischemic Cardiomyopathy: A Quantitative Assessment
Names of Authors: John A. Smith¹, Elena Rostova², David K. Chen³
Authors’ Affiliations: ¹Department of Cardiology, St. Jude Medical Center, Chicago, IL, USA; ²Division of Cardiovascular Medicine, Karolinska Institute, Stockholm, Sweden; ³Department of Electrophysiology, Tokyo University Hospital, Tokyo, Japan
Abstract: Background: Myocardial fibrosis serves as a primary substrate for ventricular arrhythmias in non-ischemic cardiomyopathy (NICM). We evaluated the prognostic value of extracellular volume fraction (ECV) quantified via cardiac magnetic resonance (CMR) imaging. Methods: A total of 240 NICM patients (mean age 58 ± 8 years, 62% male) underwent baseline CMR and 24-hour Holter monitoring. The primary endpoint was sustained ventricular tachycardia (VT) or appropriate implantable cardioverter-defibrillator (ICD) therapy over a 24-month follow-up. Results: Mean ECV was 31.4 ± 5.2%. During follow-up (median 22 months), 45 patients (18.8%) experienced VT/ICD therapy. Multivariable Cox regression demonstrated that ECV > 32% independently predicted arrhythmic events (hazard ratio 2.45, 95% confidence interval 1.58–3.80, p < 0.001). Receiver operating characteristic analysis revealed an area under the curve of 0.81 for ECV in predicting VT. Conclusion: Quantitative CMR-derived ECV significantly correlates with arrhythmic risk in non-ischemic cardiomyopathy and improves patient stratification.
Keywords: Myocardial fibrosis, Ventricular arrhythmias, Cardiomyopathy, Cardiac magnetic resonance, Extracellular volume
Manuscript Timeline: Received 12 April 2026; Revised 15 May 2026; Accepted 10 June 2026; Published 01 August 2026
Subscribe to read the full article: https://internationalscholarsjournals.org/subscribe-to-read