Remote myocardial fibrosis measured by CMR ECV strongly predicted heart failure hospitalization and death in patients with prior MI, though its correlation with infarct size was weak (0.283).
Cohort (n=1,199)
Yes
Does remote myocardial fibrosis measured by CMR ECV predict hospitalization for heart failure or all-cause mortality in patients with evidence of myocardial infarction?
Remote myocardial fibrosis quantified by CMR ECV is a strong predictor of adverse outcomes (heart failure hospitalization and death) in patients with prior myocardial infarction, independent of infarct size.
BACKGROUND: Heart failure (HF) most commonly occurs in patients who have had a myocardial infarction (MI), but factors other than MI size may be deterministic. Fibrosis of myocardium remote from the MI is associated with adverse remodeling. We aimed to 1) investigate the association between remote myocardial fibrosis, measured using cardiovascular magnetic resonance (CMR) extracellular volume fraction (ECV), and HF and death following MI, 2) identify predictors of remote myocardial fibrosis in patients with evidence of MI and determine the relationship with infarct size. METHODS: Multicenter prospective cohort study of 1199 consecutive patients undergoing CMR with evidence of MI on late gadolinium enhancement. Median follow-up was 1133 (895-1442) days. Cox proportional hazards modeling was used to identify factors predictive of the primary outcome, a composite of first hospitalization for HF (HHF) or all-cause mortality, post-CMR. Linear regression modeling was used to identify determinants of remote ECV. RESULTS: was only 0.283. The relationship between infarct size and remote fibrosis was very weak. CONCLUSION: Myocardial fibrosis, measured using CMR ECV, is a strong predictor of HHF and death in patients with evidence of MI. The mechanisms underlying remote myocardial fibrosis formation post-MI remain poorly understood, but factors other than infarct size appear to be important.
Black et al. (Mon,) conducted a cohort in Myocardial infarction (n=1,199). Remote myocardial fibrosis measured using CMR ECV was evaluated on Composite of first hospitalization for HF (HHF) or all-cause mortality, post-CMR. Remote myocardial fibrosis measured by CMR ECV strongly predicted heart failure hospitalization and death in patients with prior MI, though its correlation with infarct size was weak (0.283).