Abstract 3022: Prognostic value of late gadolinium enhancement in patients with heart failure and systolic dysfunction of uncertain etiology
Background: Late gadolinium enhancement (LGE) cardiovascular magnetic resonance has emerged as an useful diagnostic tool in the assessment of cardiomyopathies, but its prognostic value still needs to be stablished. We evaluated the prognostic value of the presence of an ischaemic pattern if LGE in patients with heart failure (HF) and systolic dysfunction (LVSD) of uncertain etiology.
Methods: Consecutive patients with HF and LVSD without a previous history of MI, neither Q waves nor clinical data suggesting CAD (n 142), were divided into two groups in relation to the presence of abscense of ischaemic LGE-CMR pattern and followed prospectively for 618 days (28–2091 days). The primary endpoint was a composite of all cause mortality and cardiac hospitalizations.
Results: LGE of ischaemc pattern was present in 50 patients (35%), and this was associated with a higher rate of mortality and hospitalization, after adjustment for anemia, ACEI treatment and atrial fibrillation (adjusted HR 3.17 CI 95% 1.648 – 6.096, p= 0.001)(see figure⇓). CAD Prognostic Index was not an independent predictor of events in multivariate analysis.
Conclusion: In patients with HF and LVSD of uncertain etiology, ischaemic LGE is a predictor of the composite event of death and hospitalization. This suggests that ischaemic LGE has a potential role in risk stratification of HF patients improving the prognostic value obtained from clinical or angiographical data.