Why the study?
The clinical course of an individual patient with heart failure is unpredictable with LVEF alone, prompting evaluation of the prognostic value of CMR-derived myocardial fibrosis extent in NICM with severely reduced LVEF.
Does the extent of late gadolinium enhancement on CMR predict major adverse cardiac events in patients with non-ischemic cardiomyopathy and severely reduced LVEF?
Does the extent of late gadolinium enhancement on CMR predict major adverse cardiac events in patients with non-ischemic cardiomyopathy and severely reduced LVEF?
In patients with non-ischemic cardiomyopathy and severely reduced LVEF, an LGE extent of 12.0% or greater on CMR is a strong predictor of long-term adverse cardiac outcomes.
OBJECTIVE: The clinical course of an individual patient with heart failure is unpredictable with left ventricle ejection fraction (LVEF) only. We aimed to evaluate the prognostic value of cardiac magnetic resonance (CMR)-derived myocardial fibrosis extent and to determine the cutoff value for event-free survival in patients with non-ischemic cardiomyopathy (NICM) who had severely reduced LVEF. MATERIALS AND METHODS: Our prospective cohort study included 78 NICM patients with significantly reduced LV systolic function (LVEF < 35%). CMR images were analyzed for the presence and extent of late gadolinium enhancement (LGE). The primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, heart transplantation, implantable cardioverter-defibrillator discharge for major arrhythmia, and hospitalization for congestive heart failure within 5 years after enrollment. CONCLUSION: In NICM patients with significantly reduced LV systolic function, the extent of LGE is a strong predictor for long-term adverse cardiac outcomes. Event-free survival was well discriminated with an LGE cutoff value of 12.0 %LV in these patients.
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Kim et al. (2020) studied this question.
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