Abstract 3207: Prognostic Value of Delayed-Enhancement Magnetic Resonance Imaging in 473 patients: 4-Year Survival Rates in Patients with Left Ventricular Dysfunction
INTRODUCTION & OBJECTIVES: Delayed-enhancement Magnetic Resonance Imaging (DE-MRI) accurately identifies irreversible myocardial injury. Left ventricular ejection fraction (LVEF) remains a powerful metric for predicting survival rate in patients with CAD. The purpose of this study was to determine if myocardial injury assessed by DE-MRI could provide additive prognostic information over LVEF alone.
METHODS: The patient population was comprised of 473 consecutive patients who underwent DE-MRI in a tertiary medical center between 2002–2003. Mortality data was obtained from the Social Security Death Index. Cine cardiac MRI was used to calculate LVEF. A standard 17-segment model was used with segments classified as having either no injury, sub-endocardial injury, or transmural injury (0%, 1–50%, 51–100% delayed-enhancement of segments, respectively).
RESULTS: There were 328 male and 145 female; age 59±14 yrs. Study cohort LVEF: 40±17%. Ninety-six patients died during a median follow up period of 1053 days. Kaplan-Meier analysis revealed significantly worse survival in patients with LV dysfunction and irreversible injury demonstrated by DE-MRI, compared to those without irreversible injury (see diagram).
CONCLUSIONS: Our data suggests that irreversible myocardial injury detected by DE-MRI provides additive prognostic information over LVEF alone in patients with reduced LVEF.