Late Gadolinium Enhancement by Cardiovascular Magnetic Resonance Heralds an Adverse Prognosis in Nonischemic Cardiomyopathy

• Published in: Journal of the American College of Cardiology 2008-06, Vol.51 (25), p.2414-2421
• Main Authors: Wu, Katherine C., MD, FACC, Weiss, Robert G., MD, Thiemann, David R., MD, Kitagawa, Kakuya, MD, Schmidt, André, MD, Dalal, Darshan, MD, Lai, Shenghan, MD, PhD, Bluemke, David A., MD, PhD, Gerstenblith, Gary, MD, FACC, Marbán, Eduardo, MD, PhD, FACC, Lima, João A.C., MD, FACC, Tomaselli, Gordon F., MD, FACC
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiomyopathies - diagnosis; Cardiomyopathies - mortality; Cardiomyopathies - physiopathology; Cardiovascular; Cardiovascular disease; Contrast Media; Defibrillators, Implantable; Disease Progression; Female; Gadolinium; Heart; Heart attacks; Hospitalization; Humans; Hypertrophy, Left Ventricular - diagnosis; Hypertrophy, Left Ventricular - physiopathology; Image Enhancement - instrumentation; Image Enhancement - methods; Imaging, Three-Dimensional - instrumentation; Imaging, Three-Dimensional - methods; Internal Medicine; Kaplan-Meier Estimate; Magnetic Resonance Imaging - instrumentation; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Myocarditis. Cardiomyopathies; NMR; Nuclear magnetic resonance; Predictive Value of Tests; Prognosis; Prospective Studies; Research Design; Risk Assessment; Stroke Volume; Time Factors; Treatment Outcome
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2008.03.018

Late Gadolinium Enhancement by Cardiovascular Magnetic Resonance Heralds an Adverse Prognosis in Nonischemic Cardiomyopathy Katherine C. Wu, Robert G. Weiss, David R. Thiemann, Kakuya Kitagawa, André Schmidt, Darshan Dalal, Shenghan Lai, David A. Bluemke, Gary Gerstenblith, Eduardo Marbán, Gordon F. Tomaselli, João A. C. Lima Predicting prognosis in nonischemic cardiomyopathy patients is challenging, and current risk stratification approaches are limited. Cardiovascular magnetic resonance (CMR) detects myocardial fibrosis, which appears as late gadolinium enhancement (LGE). The presence of LGE predicts an 8-fold increased risk of an adverse cardiac outcome (hazard ratio 8.2, 95% confidence interval 2.2 to 30.9; p = 0.002), after controlling for baseline variables. A CMR LGE may reflect the transition from compensated to decompensated state resulting from long-term stressors such as sustained adrenergic activation and/or the mechanical disadvantages caused by left ventricular remodeling leading to increasing fibrosis. Identifying CMR LGE may significantly improve risk stratification strategies in this high-risk population.