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Pattern of late gadolinium enhancement predicts arrhythmic events in patients with non-ischemic cardiomyopathy

Title
Pattern of late gadolinium enhancement predicts arrhythmic events in patients with non-ischemic cardiomyopathy
Authors
Shin D.G.Lee H.-J.Park J.Uhm J.-S.Pak H.-N.Lee M.-H.Kim Y.J.Joung B.
Ewha Authors
박준범
SCOPUS Author ID
박준범scopus
Issue Date
2016
Journal Title
International Journal of Cardiology
ISSN
0167-5273JCR Link
Citation
vol. 222, pp. 9 - 15
Keywords
Arrhythmic eventsCardiac MRILate gadolinium enhancementNonischemic cardiomyopathyPredictor
Publisher
Elsevier Ireland Ltd
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Background Left ventricular late gadolinium enhancement (LV-LGE) by cardiac magnetic resonance (CMR) imaging has been associated with adverse clinical outcomes in patients with non-ischemic cardiomyopathy (NICM). However, an association between the characteristics of the LGE and arrhythmic risk has not been demonstrated consistently. This study evaluated the impact of the LV-LGE characteristics on the arrhythmia risk in patients with NICM. Methods This study enrolled 365 consecutive patients (54 ± 15 years) with NICM who underwent CMR imaging. All patients were monitored for the following outcomes: major arrhythmic events (MA), including sustained ventricular tachycardia, an appropriate implantable cardioverter–defibrillator intervention, ventricular fibrillation and sudden cardiac death. Results During 44.3 ± 36.4 months of follow-up, 44 (12.1%) patients experienced MA. LV-LGE was observed in 40 (90.9%) and 221 (68.8%) patients with and without MA, respectively. LV-LGE was more frequently observed in the MA group (p = 0.002). The age- and sex-adjusted hazard ratio (HR) of MA was increased in patients with LGE extent ≥ 8% (HR 8.45, 95% confidence interval (CI) 2.91–24.6), and those with subendocardial (HR 6.98, 95% CI 1.74–28.0) and subepicardial LGE patterns (HR 7.2, 95% CI 1.61–35.6). In multivariable models adjusted for other clinical variables, only the subepicardial LGE pattern had 7.2 (95% CI, 1.61–32.6, p = 0.01) time increase in the MA risk. Conclusions LV-LGE in patients with NICM is not uncommon. The subepicardial pattern of the LV-LGE was an independent predictor of MA, suggesting that specific patterns of the LV-LGE are closely related to the severity of arrhythmic events. © 2016 Elsevier Ireland Ltd
DOI
10.1016/j.ijcard.2016.07.122
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의학전문대학원 > 의학과 > Journal papers
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