Abstract 16977: Prognostic Significance of Late Gadolinium Enhanced Magnetic Resonance Imaging in Patients With Heart Failure With Preserved Ejection Fraction (HFPEF)
Background: Late gadolinium enhanced magnetic resonance imaging (LGE-MRI) allows for accurate assessment of myocardial fibrosis and infarction with high spatial resolution. The aim of this study was to investigate the prognostic value of LGE-MRI in patients with heart failure with preserved ejection fraction (HFPEF).
Materials and Methods: We studied 59 patients (mean age: 69.3 ± 10.2 years) with HFPEF. We evaluated cardiac function by using echocardiography to measure the ratio of early transmitral flow velocity to tissue Doppler early diastolic mitral annular velocity (E/e’). We applied the diagnostic criteria of the European Working Group to HFPEF (1). LGE-MRI was performed to evaluate the presence or absence of late enhancement. Major adverse cardiac events (MACEs) were defined as cardiovascular death, acute myocardial infarction, unstable angina, heart failure (HF), ischemic stroke, and coronary revascularization.
Results: LGE was found in 36 of 59 (61%) patients with HFPEF. During a median follow up duration of 29 month, 18 MACEs (2 cardiovascular death, 5 hospitalization for HF decompensation, 4 unstable angina, 4 ischemic stroke, 3 coronary revascularization) were observed in 36 patients with LGE. In 23 patients without LGE, 2 hospitalization for HF decompensation were observed during follow-up period. Kaplan-Meier curves demonstrated a significant difference in event-free survival between two groups (log-rank test, p= 0.003). Multivariate Cox proportional hazard analysis showed that presence of LGE was independent predictor of MACEs (hazard ratio: 12.17; 95% confidence interval: 2.58-57.56, p=0.002).
Conclusions: The results in the current study indicated that the presence of myocardial enhancement on LGE-MRI was independent prognostic marker in patients with HFPEF.
1. Paulus WJ, Tschope C, Sanderson JE, et al. Eur Heart J. 2007;28(20):2539-50.
- © 2013 by American Heart Association, Inc.