Abstract 10758: Prognostic Importance of Late Gadolinium Enhancement Cardiac Magnetic Resonance as a Potential Novel Risk Factor in Patients with Dilated Cardiomyopathy
Background: Cardiac magnetic resonance (CMR) has revolutionized providing information regarding cardiac anatomy and function, particularly through the use of late gadolinium enhancement (LGE) imaging for tissue characterization. Since traditional risk markers do not at present adequately predict outcomes in dilated cardiomyopathy (DCM), we hypothesized whether the presence of LGE is a useful predictor for cardiac events.
Methods: The present study includes 218 DCM patients who underwent LGE between 2005 and 2011 (M/F 170/48; age 54±16 years). Patients were divided into the 2 groups according to the presence (n=164) or absence (n=54) of LGE, and were prospectively followed. The primary end points were composed of cardiac death, implantation of left ventricular assist device / transplantation, hospitalization due to decompensated heart failure, or appropriate discharge of implantable cardioverter defibrillator.
Results: Between the LGE and non-LGE groups, left ventricular ejection fraction (LVEF) (LGE, 25.7±1.4% vs. non-LGE, 24.2±0.8% p=NS) and right ventricular ejection fraction (LGE, 35.3±1.5% vs. non-LGE, 35.0±0.8%, p=NS) were comparable. During median 3 year follow-up period, the presence of LGE was significantly associated with cardiac events (log-rank p=0.0017). Importantly, multivariate Cox regression analysis showed the presence of LGE as the strongest predictor of cardiac events (hazard ratio [HR]: 1.85, p=0.014) in comparisons with other traditional risk factors including LV end diastolic volume index (HR: 1.09, p=0.008), LVEF (HR: 1.03, p=NS), and QRS duration (HR: 1.08; 95%CI: 0.05 to 1.01, p=0.013).
Conclusion: These findings indicate that characterization of the myocardium using LGE is a potential novel risk factor for adverse events in patients with DCM.
- © 2012 by American Heart Association, Inc.