Background: The purpose of this study was to find out that early mitral inflow to early diastolic tissue velocity ratio(E/E���)and Pro-BNP level would predict the cardiac event and add incremental value to clinical risk factors in patients with severe LV dysfunction of non-ischemic DCMP.Methods:The study subjects consisted of 46 patients, 3 with alcoholic,6 with hypertensive and 37 with idiopathic DCMP who had been evaluated with echocardiography and Pro-BNP level. Patients were followed up for a mean 291 days.The development of clinical events was defined as the composite of cardiac death, non-fatal stroke and readmission for recurrent heart failure.Results: Of all the subjects (mean age: 57yrs,mean EF:30%),there were 12 cardiovascular events. No significant differences were found between the patients with(Group I)or without further cardiovascular events(Group II)as regards age,a history of diabetes and smoking,EF and E/E���.The patients in group I had a trend towards more frequency of hypertension and had a significant higher level of Pro-BNP level(7351vs.2487 pg/mL; p=0.007).In the Cox-hazard model,hypertension,diabetes,Pro-BNP,EF and E/E���were significantly independent predictors of cardiovascular events.Pro-BNP had a significant incremental value to clinical histories of hypertension and diabetes, more over the incremental value of E/E���.Conclusion: The level of E/E���and Pro-BNP would be useful prognostic factors and have the incremental value in prediction for further cardiovascular events in the severe LV dysfunction of non-ischemic DCMP.