Implications of multiple late gadolinium enhancement lesions on the frequency of left ventricular reverse remodeling and prognosis in patients with non‐ischemic cardiomyopathy
| Autor: | Kazushi Takemoto, Mao Yokoyama, Ryoko Matsushita, Takashi Tanimoto, Takashi Akasaka, Takeshi Hozumi, Shingo Ota, Kumiko Hirata, Tsuyoshi Nishiguchi, Makoto Orii |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Gadolinium DTPA
Male medicine.medical_specialty lcsh:Diseases of the circulatory (Cardiovascular) system Cardiomyopathy Contrast Media Magnetic Resonance Imaging Cine 030204 cardiovascular system & hematology Risk Assessment Ventricular Function Left Sudden cardiac death 03 medical and health sciences 0302 clinical medicine Reverse remodeling Multiple late gadolinium enhancement lesions Predictive Value of Tests Risk Factors Internal medicine medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Registries cardiovascular diseases Angiology Aged Retrospective Studies Ejection fraction Non‐ischemic cardiomyopathy Radiological and Ultrasound Technology medicine.diagnostic_test Ventricular Remodeling business.industry Research Hazard ratio Magnetic resonance imaging Middle Aged medicine.disease Prognosis lcsh:RC666-701 Heart failure Ventricular fibrillation embryonic structures Cardiology Female Cardiovascular magnetic resonance Cardiology and Cardiovascular Medicine business Cardiomyopathies |
| Zdroj: | Journal of Cardiovascular Magnetic Resonance, Vol 23, Iss 1, Pp 1-10 (2021) Journal of Cardiovascular Magnetic Resonance |
| Popis: | Background Non-ischemic cardiomyopathy (NICM) is a heterogeneous disease, and its prognosis varies. Although late gadolinium enhancement (LGE)-cardiovascular magnetic resonance (CMR) demonstrates a linear pattern in the mid-wall of the septum or multiple LGE lesions in patients with NICM, the therapeutic response and prognosis of multiple LGE lesions have not been elucidated. This study aimed to investigate the frequency of left ventricular (LV) reverse remodeling (LVRR) and prognosis in patients with NICM who have multiple LGE lesions. Methods This single-center retrospective study included 101 consecutive patients with NICM who were divided into 3 groups according to LGE-CMR results: patients without LGE (no LGE group = 48 patients), patients with a typical mid-wall LGE pattern (n = 29 patients), and patients with multiple LGE lesions (n = 24 patients). LVRR was defined as an increase in LV ejection fraction (LVEF) ≥ 10 % and a final value of LVEF > 35 %, which was accompanied by a decrease in LV end-systolic volume ≥ 15 % at 12-month follow-up using echocardiography. The frequency of composite cardiac events, defined as sudden cardiac death (SCD), aborted SCD (non-fatal ventricular fibrillation, sustained ventricular tachycardia, or adequate implantable cardioverter-defibrillator therapies), and heart failure death or hospitalization for worsening heart failure, were summarized and compared between the groups. Results Among the 3 groups, the frequency of LVRR was significantly lower in the multiple lesions group than in the no LGE and mid-wall groups (no LGE vs. mid-wall vs. multiple lesions: 49 % vs. 52 % vs. 19 %, p = 0.03). There were 24 composite cardiac events among the patients: 2 in patients without LGE (hospitalization for worsening heart failure; 2), 7 in patients of the mid-wall group (SCD; 1, aborted SCD; 1 and hospitalization for worsening heart failure; 5), and 15 in patients of the multiple lesions group (SCD; 1, aborted SCD; 8 and hospitalization for worsening heart failure; 6). The multiple LGE lesions was an independent predictor of composite cardiac events (hazard ratio: 11.40 [95 % confidence intervals: 1.49−92.01], p = 0.020). Conclusions Patients with multiple LGE lesions have a higher risk of cardiac events and poorer LVRR. The LGE pattern may be useful for an improved risk stratification in patients with NICM. |
| Databáze: | OpenAIRE |
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