Late gadolinium enhancement on CMR imaging in patients with idiopathic dilated cardiomyopathy was associated with mortality at one year (HR 0.435; 95% CI 0.259-0.731; p=0.002).
Cohort (n=78)
What are the CMR imaging findings and their prognostic significance for 1-year mortality in an African cohort with idiopathic dilated cardiomyopathy?
In a Southern African cohort with idiopathic dilated cardiomyopathy, CMR revealed late gadolinium enhancement in over half of the patients, which was significantly associated with 1-year mortality risk.
Effect estimate: HR 0.435 (95% CI 0.259-0.731)
p-value: p=0.002
In sub-Saharan Africa, idiopathic dilated cardiomyopathy (IDCM) is a common yet poorly investigated cause of heart failure. Cardiovascular magnetic resonance (CMR) imaging is the gold standard for tissue characterisation and volumetric quantification. In this paper, we present CMR findings obtained from a cohort of patients with IDCM in Southern Africa suspected of having a genetic cause of cardiomyopathy. A total of 78 IDCM study participants were referred for CMR imaging. The participants had a median left ventricular ejection fraction of 24% interquartile range, (IQR): 18–34. Late gadolinium enhancement (LGE) was visualised in 43 (55.1%) participants and localised in the midwall in 28 (65.0%) participants. At the time of enrolment into the study, non-survivors had a higher median left ventricular end diastolic wall mass index of 89.4 g/m2 (IQR: 74.5–100.6) vs. 73.6 g/m2 (IQR: 51.9–84.7), p = 0.025 and a higher median right ventricular end-systolic volume index of 86 mL/m2 (IQR:74–105) vs. 41 mL/m2 (IQR: 30–71), p < 0.001. After one year, 14 participants (17.9%) died. The hazard ratio for the risk of death in patients with evidence of LGE from CMR imaging was 0.435 (95% CI: 0.259–0.731; p = 0.002). Midwall enhancement was the most common pattern, visualised in 65% of participants. Prospective, adequately powered, and multi-centre studies across sub-Saharan Africa are required to determine the prognostic significance of CMR imaging parameters such as late gadolinium enhancement, extracellular volume fraction, and strain patterns in an African IDCM cohort.
Tsabedze et al. (Wed,) conducted a cohort in Idiopathic Dilated Cardiomyopathy (n=78). Cardiovascular magnetic resonance (CMR) imaging was evaluated on Death (HR 0.435, 95% CI 0.259-0.731, p=0.002). Late gadolinium enhancement on CMR imaging in patients with idiopathic dilated cardiomyopathy was associated with mortality at one year (HR 0.435; 95% CI 0.259-0.731; p=0.002).