Key result
Septal midwall LGE predicts arrhythmias overall but links to ~92% higher mortality only in DCM.
Why the study?
Septal midwall late gadolinium enhancement is a known prognostic finding in nonischemic dilated cardiomyopathy, but its significance in ischemic cardiomyopathy was unknown.
Does the presence of septal midwall LGE on CMR predict mortality and ventricular arrhythmias in patients with ischemic and nonischemic cardiomyopathy?
Observational (n=1,084)
Yes
Does the presence of septal midwall LGE on CMR predict mortality and ventricular arrhythmias in patients with ischemic and nonischemic cardiomyopathy?
Effect estimate: HR 1.92 (DCM) / HR 1.35 (ICM)
p-value: p=0.03 (DCM) / 0.39 (ICM)
Septal midwall LGE on CMR, traditionally a prognostic marker in nonischemic dilated cardiomyopathy, is also present in 10% of ischemic cardiomyopathy patients and strongly predicts ventricular arrhythmias in both etiologies.
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May extend septal midwall LGE to VA risk stratification in ICM; leaves open mortality prediction in ICM.
Becker et al. (2023) conducted an observational in Ischemic cardiomyopathy (ICM) and nonischemic dilated cardiomyopathy (DCM) (n=1,084). Septal midwall late gadolinium enhancement (LGE) vs. Absence of septal midwall LGE was evaluated on All-cause mortality (HR 1.92 (DCM) / HR 1.35 (ICM), p=0.03 (DCM) / 0.39 (ICM)). Septal midwall LGE was associated with increased all-cause mortality in DCM (HR 1.92, p=0.03) but not in ICM (HR 1.35, p=0.39), though it predicted ventricular arrhythmias in both etiologies.
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