Magnetic resonance imaging of dilated cardiomyopathy: prognostic benefit of identifying late gadolinium enhancement in Asian patients

Infante, Anna Nogue; Koo, Christopher Chieh Yang; Yip, Alfred; Lim, Ying Hao; Yeo, Wee‐Song; Quek, Swee Tian; Lim, Toon Wei; Seow, Swee Chong; Chai, Ping; Ong, Ching Ching; Teo, Lynette; Singh, Devinder; Kojodjojo, Pipin

doi:10.11622/smedj.2019166

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…Thirty studies with a total of 7541 patients reported major ventricular arrhythmic events, which occurred in 810 patients (10.7%) 4 , 9 , 16 – 19 , 25 – 28 , 31 – 33 , 35 , 37 – 39 , 42 – 44 , 46 , 51 , 57 , 60 , 62 , 63 , 66 , 68 , 71 . The pooled OR and rates of major ventricular arrhythmic events were shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-four studies with a total of 5807 patients reported cardiovascular mortality, which occurred in 734 patients (12.6%) 9 , 10 , 17 , 21 , 29 – 31 , 33 , 35 , 37 – 40 , 43 , 44 , 48 , 51 , 57 , 58 , 62 , 63 , 66 , 68 , 71 . The pooled OR and rates of cardiovascular mortality were shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Fifty-two studies with a total of 10,923 patients reported MACE, which occurred in 2736 patients (25.1%) 9 , 10 , 15 , 17 , 18 , 20 – 26 , 28 , 29 , 31 , 33 – 37 , 39 – 54 , 56 – 71 . The pooled OR and rates of MACE were shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

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Impact of late gadolinium-enhanced cardiac MRI on arrhythmic and mortality outcomes in nonischemic dilated cardiomyopathy: updated systematic review and meta-analysis

Theerasuwipakorn,

Chokesuwattanaskul,

Phannajit

et al. 2023

Sci Rep

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Risk stratification based mainly on the impairment of left ventricular ejection fraction has limited performance in patients with nonischemic dilated cardiomyopathy (NIDCM). Evidence is rapidly growing for the impact of myocardial scar identified by late gadolinium enhancement (LGE) cardiac magnetic resonance imaging (CMR) on cardiovascular events. We aim to assess the prognostic value of LGE on long-term arrhythmic and mortality outcomes in patients with NIDCM. PubMed, Scopus, and Cochrane databases were searched from inception to January 21, 2022. Studies that included disease-specific subpopulations of NIDCM were excluded. Data were independently extracted and combined via random-effects meta-analysis using a generic inverse-variance strategy. Data from 60 studies comprising 15,217 patients were analyzed with a 3-year median follow-up. The presence of LGE was associated with major ventricular arrhythmic events (pooled OR: 3.99; 95% CI 3.08, 5.16), all-cause mortality (pooled OR: 2.14; 95% CI 1.81, 2.52), cardiovascular mortality (pooled OR 2.83; 95% CI 2.23, 3.60), and heart failure hospitalization (pooled OR: 2.53; 95% CI 1.78, 3.59). Real-world evidence suggests that the presence of LGE on CMR was a strong predictor of adverse long-term outcomes in patients with NIDCM. Scar assessment should be incorporated as a primary determinant in the patient selection criteria for primary prophylactic implantable cardioverter-defibrillator placement.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Impact of late gadolinium-enhanced cardiac MRI on arrhythmic and mortality outcomes in nonischemic dilated cardiomyopathy: updated systematic review and meta-analysis

Theerasuwipakorn,

Chokesuwattanaskul,

Phannajit

et al. 2023

Sci Rep

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Risk Stratification in Nonischemic Dilated Cardiomyopathy Using CMR Imaging

Eichhorn,

Koeckerling,

Reddy

et al. 2024

JAMA

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ImportanceAccurate risk stratification of nonischemic dilated cardiomyopathy (NIDCM) remains challenging.ObjectiveTo evaluate the association of cardiac magnetic resonance (CMR) imaging–derived measurements with clinical outcomes in NIDCM.Data SourcesMEDLINE, Embase, Cochrane Library, and Web of Science Core Collection databases were systematically searched for articles from January 2005 to April 2023.Study SelectionProspective and retrospective nonrandomized diagnostic studies reporting on the association between CMR imaging–derived measurements and adverse clinical outcomes in NIDCM were deemed eligible.Data Extraction and SynthesisPrespecified items related to patient population, CMR imaging measurements, and clinical outcomes were extracted at the study level by 2 independent reviewers. Random-effects models were fitted using restricted maximum likelihood estimation and the method of Hartung, Knapp, Sidik, and Jonkman.Main Outcomes and MeasuresAll-cause mortality, cardiovascular mortality, arrhythmic events, heart failure events, and major adverse cardiac events (MACE).ResultsA total of 103 studies including 29 687 patients with NIDCM were analyzed. Late gadolinium enhancement (LGE) presence and extent (per 1%) were associated with higher all-cause mortality (hazard ratio [HR], 1.81 [95% CI, 1.60-2.04]; P &lt; .001 and HR, 1.07 [95% CI, 1.02-1.12]; P = .02, respectively), cardiovascular mortality (HR, 2.43 [95% CI, 2.13-2.78]; P &lt; .001 and HR, 1.15 [95% CI, 1.07-1.24]; P = .01), arrhythmic events (HR, 2.69 [95% CI, 2.20-3.30]; P &lt; .001 and HR, 1.07 [95% CI, 1.03-1.12]; P = .004) and heart failure events (HR, 1.98 [95% CI, 1.73-2.27]; P &lt; .001 and HR, 1.06 [95% CI, 1.01-1.10]; P = .02). Left ventricular ejection fraction (LVEF) (per 1%) was not associated with all-cause mortality (HR, 0.99 [95% CI, 0.97-1.02]; P = .47), cardiovascular mortality (HR, 0.97 [95% CI, 0.94-1.00]; P = .05), or arrhythmic outcomes (HR, 0.99 [95% CI, 0.97-1.01]; P = .34). Lower risks for heart failure events (HR, 0.97 [95% CI, 0.95-0.98]; P = .002) and MACE (HR, 0.98 [95% CI, 0.96-0.99]; P &lt; .001) were observed with higher LVEF. Higher native T1 relaxation times (per 10 ms) were associated with arrhythmic events (HR, 1.07 [95% CI, 1.01-1.14]; P = .04) and MACE (HR, 1.06 [95% CI, 1.01-1.11]; P = .03). Global longitudinal strain (GLS) (per 1%) was not associated with heart failure events (HR, 1.06 [95% CI, 0.95-1.18]; P = .15) or MACE (HR, 1.03 [95% CI, 0.94-1.14]; P = .43). Limited data precluded definitive analysis for native T1 relaxation times, GLS, and extracellular volume fraction (ECV) with respect to mortality outcomes.ConclusionThe presence and extent of LGE were associated with various adverse clinical outcomes, whereas LVEF was not significantly associated with mortality and arrhythmic end points in NIDCM. Risk stratification using native T1 relaxation times, extracellular volume fraction, and global longitudinal strain requires further evaluation.

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The Influence of Arrhythmia on the Outcomes of Pediatric Patients with Idiopathic Dilated Cardiomyopathy

Dalili,

Dastafshan,

Mahdavi

et al. 2024

Pediatr Cardiol

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Magnetic resonance imaging of dilated cardiomyopathy: prognostic benefit of identifying late gadolinium enhancement in Asian patients

Cited by 3 publications

References 28 publications

Impact of late gadolinium-enhanced cardiac MRI on arrhythmic and mortality outcomes in nonischemic dilated cardiomyopathy: updated systematic review and meta-analysis

Impact of late gadolinium-enhanced cardiac MRI on arrhythmic and mortality outcomes in nonischemic dilated cardiomyopathy: updated systematic review and meta-analysis

Risk Stratification in Nonischemic Dilated Cardiomyopathy Using CMR Imaging

The Influence of Arrhythmia on the Outcomes of Pediatric Patients with Idiopathic Dilated Cardiomyopathy

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