Abstract 11013: Predictive Role of Late Gadolinium Enhancement on Cardiac Magnetic Resonance in Hypertrophic Cardiomyopathy: An Updated Meta-Analysis
Background: Myocardial fibrosis detected by late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) is currently used to predict adverse cardiovascular events in patients with hypertrophic cardiomyopathy (HCM). However, controversies remain about its prediction value of sudden cardiac death (SCD).
Objective: The aim of this study was to perform an updated meta-analysis of the prediction value of late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) for future events and death in hypertrophic cardiomyopathy (HCM).
Methods: We searched PubMed and Web of Science for clinical trials that investigated the prognosis indexes of LGE in HCM patients. The outcomes of interest comprised all-cause mortality, cardiac death, SCD, aborted SCD and heart failure death. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the role of LGE CMR in the risk stratification of HCM.
Results: Seven studies were retrieved from 393 citations for the analysis, and in total, 3423 patients (mean age: 52.3 years; median follow up: 37.7 months) were included in the analysis. After synthesizing data, the meta-analysis showed that LGE by CMR was associated with SCD/Aborted SCD (OR=2.921, 95%CI=1.760-4.848; P<0.001) and all cause mortality (OR=1.715, 95%CI=1.013-2.901; P=0.044), and showed a trend toward significance of predicting cardiac death (OR=2.174, 95%CI=1.000-4.727; P=0.05). However, we did not observe a correlation between LGE and heart failure death (OR=2.066, 95%CI=0.788-5.416; P=0.14).
Conclusions: LGE by CMR exhibited a substantial prognostic value in SCD events prediction. Significant associations were found between LGE and SCD, and all cause mortality. Moreover, LGE displayed a trend toward significance on cardiac death but not on heart failure death. Myocardial fibrosis assessed by LGE is effective in SCD risk stratification in patients with HCM.
- Late gadolinium enhancement
- Cardiac magnetic resonance
- Hypertrophic cardiomyopathy
- Sudden cardiac death
Author Disclosures: J. Yao: None. Y. Zhou: None. X. Yang: None. X. Qian: None.
- © 2015 by American Heart Association, Inc.