The presence of late gadolinium enhancement in dilated cardiomyopathy was associated with increased risks of all-cause mortality (HR 2.14) and arrhythmic events (HR 5.12) (all P<0.001).
Meta-Analysis (n=7,330)
Does the presence and extent of late gadolinium enhancement on CMR predict adverse outcomes in patients with dilated cardiomyopathy?
The presence and extent of late gadolinium enhancement on CMR is a strong predictor of all-cause mortality and arrhythmic events in patients with dilated cardiomyopathy.
Hazard Ratio: 2.14
p-value: p=<0.001
BACKGROUND The prognostic value of late gadolinium enhancement (LGE) derived from cardiovascular magnetic resonance (CMR) is well studied, and several new metrics of LGE have emerged. However, some controversies remain; therefore, further discussion is needed, and more precise risk stratification should be explored. AIM To investigate the associations between the positivity, extent, location, and pattern of LGE and multiple outcomes in dilated cardiomyopathy (DCM). METHODS PubMed, Ovid MEDLINE, and Cochrane Library were searched for studies that investigated the prognostic value of LGE in patients with DCM. Pooled hazard ratios (HRs) and 95% confidence intervals were calculated to assess the role of LGE in the risk stratification of DCM. RESULTS Nineteen studies involving 7330 patients with DCM were included in this meta-analysis and covered a wide spectrum of DCM, with a mean left ventricular ejection fraction between 21% and 50%. The meta-analysis revealed that the presence of LGE was associated with an increased risk of multiple adverse outcomes (all-cause mortality, HR: 2.14; arrhythmic events, HR: 5.12; and composite endpoints, HR: 2.38; all P < 0.001). Furthermore, every 1% increment in the extent of LGE was associated with an increased risk of all-cause mortality. Analysis of a subgroup revealed that the prognostic value varied based on different location and pattern of LGE. Additionally, we found that LGE was a stronger predictor of arrhythmic events in patients with greater left ventricular ejection fraction. CONCLUSION LGE by CMR in patients with DCM exhibited a substantial value in predicting adverse outcomes, and the extent, location, and pattern of LGE could provide additional information for risk stratification.
Feng et al. (Fri,) conducted a meta-analysis in Dilated cardiomyopathy (DCM) (n=7,330). Late gadolinium enhancement (LGE) vs. Absence of LGE was evaluated on All-cause mortality (HR 2.14, p=<0.001). The presence of late gadolinium enhancement in dilated cardiomyopathy was associated with increased risks of all-cause mortality (HR 2.14) and arrhythmic events (HR 5.12) (all P<0.001).