Abstract 14332: Clinical Significance of the Late Gadolinium Enhancement Patterns of Cardiovascular Magnetic Resonance to Predict Prognosis in Dilated Cardiomyopathy
Background: Although late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR) is an independent predictor of cardiac events in patients with idiopathic dilated cardiomyopathy (IDCM), the prognostic impact of LGE patterns remains unclear.
Methods and results: We enrolled 96 consecutive patients with newly diagnosed IDCM who underwent LGE-CMR imaging between 2007 and 2012. The patients with positive LGE (n=48) were divided into the 2 groups according to the LGE pattern: midwall or patchy LGE (M; n=39), endocardial or epicardial LGE (E; n=9). As baseline characteristics, significantly lower systolic blood pressure, higher serum levels of B-type natriuretic peptide and higher proportion of myocardial fibrosis in the endomyocardial biopsy specimens were observed in the group E as compared to those in the group M, although there was no significant difference in left ventricular ejection fraction between the 2 groups. Among the groups with optimal medical therapy, the group E was associated with markedly higher subsequent cardiac events (5/9, 55% in E group vs. 8/39, 21% in M group vs. 2/48, 4% in the group without LGE-CMR (N; n=48); P<0.001), defined as sudden death, readmission for heart failure exacerbation, and major ventricular arrhythmias. Kaplan-Meier analysis also revealed a significantly lower event-free survival rate during the follow-up period (988 ± 573 days) in the group E than in the group N (P<0.001) or the group M (P<0.05)(Figure).
Conclusion: The IDCM patients with endocardial or epicardial LGE pattern have worse prognosis for the cardiac events compared to those with the other LGE patterns.
- © 2013 by American Heart Association, Inc.