Objective criteria for septal fibrosis in non-ischemic dilated cardiomyopathy: validation for the prediction of future cardiovascular events

Mikami, Yoko; Cornhill, Aidan; Heydari, Bobak; Joncas, Sebastien X; Almehmadi, Fahad; Zahrani, Mohammed; Bokhari, Mahmoud; Stirrat, John; Yee, Raymond; Merchant, Naeem; Lydell, Carmen; Howarth, Andrew G; White, James A.

doi:10.1186/s12968-016-0300-z

Cited by 37 publications

(28 citation statements)

References 20 publications

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“…It has been shown that even a small amount of LGE has prognostic implications in cardiomyopathies [ 31 – 34 ]. In case of inflammatory heart disease missed small subepicardial LGE may even impact diagnosis [ 35 ], as Lake Louise criteria define myocarditis as two out of three parameters, LGE being one of them [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of fast multi-slice and standard segmented techniques for detection of late gadolinium enhancement in ischemic and non-ischemic cardiomyopathy – a prospective clinical cardiovascular magnetic resonance trial

Muehlberg

Arnhold

Fritschi

et al. 2018

Journal of Cardiovascular Magnetic Resonance

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BackgroundSegmented phase-sensitive inversion recovery (PSIR) cardiovascular magnetic resonance (CMR) sequences are reference standard for non-invasive evaluation of myocardial fibrosis using late gadolinium enhancement (LGE). Several multi-slice LGE sequences have been introduced for faster acquisition in patients with arrhythmia and insufficient breathhold capability.The aim of this study was to assess the accuracy of several multi-slice LGE sequences to detect and quantify myocardial fibrosis in patients with ischemic and non-ischemic myocardial disease.MethodsPatients with known or suspected LGE due to chronic infarction, inflammatory myocardial disease and hypertrophic cardiomyopathy (HCM) were prospectively recruited. LGE images were acquired 10–20 min after administration of 0.2 mmol/kg gadolinium-based contrast agent. Three different LGE sequences were acquired: a segmented, single-slice/single-breath-hold fast low angle shot PSIR sequence (FLASH-PSIR), a multi-slice balanced steady-state free precession inversion recovery sequence (bSSFP-IR) and a multi-slice bSSFP-PSIR sequence during breathhold and free breathing. Image quality was evaluated with a 4-point scoring system. Contrast-to-noise ratios (CNR) and acquisition time were evaluated. LGE was quantitatively assessed using a semi-automated threshold method. Differences in size of fibrosis were analyzed using Bland-Altman analysis.ResultsThree hundred twelve patients were enrolled (n = 212 chronic infarction, n = 47 inflammatory myocardial disease, n = 53 HCM) Of which 201 patients (67,4%) had detectable LGE (n = 143 with chronic infarction, n = 27 with inflammatory heart disease and n = 31 with HCM). Image quality and CNR were best on multi-slice bSSFP-PSIR. Acquisition times were significantly shorter for all multi-slice sequences (bSSFP-IR: 23.4 ± 7.2 s; bSSFP-PSIR: 21.9 ± 6.4 s) as compared to FLASH-PSIR (361.5 ± 95.33 s). There was no significant difference of mean LGE size for all sequences in all study groups (FLASH-PSIR: 8.96 ± 10.64 g; bSSFP-IR: 8.69 ± 10.75 g; bSSFP-PSIR: 9.05 ± 10.84 g; bSSFP-PSIR free breathing: 8.85 ± 10.71 g, p > 0.05).LGE size was not affected by arrhythmia or absence of breathhold on multi-slice LGE sequences.ConclusionsFast multi-slice and standard segmented LGE sequences are equivalent techniques for the assessment of myocardial fibrosis, independent of an ischemic or non-ischemic etiology. Even in patients with arrhythmia and insufficient breathhold capability, multi-slice sequences yield excellent image quality at significantly reduced scan time and may be used as standard LGE approach.Trial registrationISRCTN48802295 (retrospectively registered).

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Section: Discussionmentioning

confidence: 99%

Comparison of fast multi-slice and standard segmented techniques for detection of late gadolinium enhancement in ischemic and non-ischemic cardiomyopathy – a prospective clinical cardiovascular magnetic resonance trial

Muehlberg

Arnhold

Fritschi

et al. 2018

Journal of Cardiovascular Magnetic Resonance

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“…In addition, late gadolinium enhancement, an independent supplementary negative prognostic sign, was found in 75% of patients in the overlapping phenotypes group [ 33 ]. The most common morphotype of LGE was linear, followed by focal, and the least common was the diffuse type; the latter particularly points toward increased risk of long-term adverse cardiovascular events [ 34 ]. The reason for such a distribution could be the greater prevalence of DCM and LVNC among patients with dilated left ventricles.…”

Section: Discussionmentioning

confidence: 99%

Overlapping Phenotypes and Degree of Ventricular Dilatation Are Associated with Severity of Systolic Impairment and Late Gadolinium Enhancement in Non-Ischemic Cardiomyopathies

et al. 2018

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BackgroundDilatation and other infrastructural rearrangements of the left ventricle are connected with poor prognosis. The aim of our study was to analyze the overlapping phenotypes and dilatation of the ventricle on impairment of systolic function and existence of late gadolinium enhancement (LGE).Material/MethodsConsecutive sample of cases with dilated left ventricle due to non-ischemic cardiomyopathy and healthy controls were included from our cardiac magnetic resonance imaging (CMR) database for a period of 3 years (n=1551 exams).ResultsThe study included 127 patients; 30 (23.6%) with dilated cardiomyopathy (DCM); 30 (23.6%) with left ventricular non-compaction (LVNC); 13 (10.2%) with hypertrophic cardiomyopathy (HCM), and 50 (39.4%) controls. Overlapping phenotypes were found in 48 (37.8%) of the studied cases. Odds for impairment of systolic function in connection with overlapping phenotypes were estimated at 7.8 (95%-CI: 3.4–17.6), (p<0.001). There were significant differences in geometric parameters for patients with overlapping phenotypes vs. controls, as follows: left ventricle end-diastolic dimension(LVEDD)=6.6±0.8 vs. 5.6±1.0 cm (p<0.001); left ventricular ejection fraction (LVEF)=39.3±14.0 vs. 52.1±16.1 (p<0.001); and existence of LGE 36 (75.0%) vs. 21 (26.6%), (p<0.001), respectively. Overlapping phenotypes correlated with LVEDD (Spearman’s-Rho-CC)=0.521, p<0.001; LVEF (Rho-CC)=−0.447, p<0.001 and LGE (Rho-CC)=0.472, p<0.001.ConclusionsThis study found there are many patients with overlapping phenotypes among NICMPs with dilated left ventricles. Overlapping phenotype was associated with greater LVEDD, lesser systolic function, and commonly existing LGE, which all impose increased cardiovascular risk. Linear midventricular LGE stripe was the most powerfully connected with loss of systolic function.

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“…Expert subjective mid-wall septal fibrosis on late gadolinium enhancement (LGE) CM R has been shown to predict major adverse cardiovascular outcomes. Mikami et al [ 28 ] sought to establish objective criteria for non-experts and studied 118 consecutive patients with a non-ischemic cardiomyopathy and septal fibrosis identified by an expert reader. CMR naïve readers performed signal threshold-based LGE quantification.…”

Section: Cardiomyopathiesmentioning

confidence: 99%

Review of Journal of Cardiovascular Magnetic Resonance (JCMR) 2015-2016 and transition of the JCMR office to Boston

Manning

2016

Journal of Cardiovascular Magnetic Resonance

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The Journal of Cardiovascular Magnetic Resonance (JCMR) is the official publication of the Society for Cardiovascular Magnetic Resonance (SCMR). In 2016, the JCMR published 93 manuscripts, including 80 research papers, 6 reviews, 5 technical notes, 1 protocol, and 1 case report. The number of manuscripts published was similar to 2015 though with a 12% increase in manuscript submissions to an all-time high of 369. This reflects a decrease in the overall acceptance rate to <25% (excluding solicited reviews). The quality of submissions to JCMR continues to be high. The 2016 JCMR Impact Factor (which is published in June 2016 by Thomson Reuters) was steady at 5.601 (vs. 5.71 for 2015; as published in June 2016), which is the second highest impact factor ever recorded for JCMR. The 2016 impact factor means that the JCMR papers that were published in 2014 and 2015 were on-average cited 5.71 times in 2016.In accordance with Open-Access publishing of Biomed Central, the JCMR articles are published on-line in the order that they are accepted with no collating of the articles into sections or special thematic issues. For this reason, over the years, the Editors have felt that it is useful to annually summarize the publications into broad areas of interest or themes, so that readers can view areas of interest in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes with previously published JCMR papers to guide continuity of thought in the journal. In addition, I have elected to open this publication with information for the readership regarding the transition of the JCMR editorial office to the Beth Israel Deaconess Medical Center, Boston and the editorial process.Though there is an author publication charge (APC) associated with open-access to cover the publisher’s expenses, this format provides a much wider distribution/availability of the author’s work and greater manuscript citation. For SCMR members, there is a substantial discount in the APC. I hope that you will continue to send your high quality manuscripts to JCMR for consideration. Importantly, I also ask that you consider referencing recent JCMR publications in your submissions to the JCMR and elsewhere as these contribute to our impact factor. I also thank our dedicated Associate Editors, Guest Editors, and reviewers for their many efforts to ensure that the review process occurs in a timely and responsible manner and that the JCMR continues to be recognized as the leading publication in our field.

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Objective criteria for septal fibrosis in non-ischemic dilated cardiomyopathy: validation for the prediction of future cardiovascular events

Cited by 37 publications

References 20 publications

Comparison of fast multi-slice and standard segmented techniques for detection of late gadolinium enhancement in ischemic and non-ischemic cardiomyopathy – a prospective clinical cardiovascular magnetic resonance trial

Comparison of fast multi-slice and standard segmented techniques for detection of late gadolinium enhancement in ischemic and non-ischemic cardiomyopathy – a prospective clinical cardiovascular magnetic resonance trial

Overlapping Phenotypes and Degree of Ventricular Dilatation Are Associated with Severity of Systolic Impairment and Late Gadolinium Enhancement in Non-Ischemic Cardiomyopathies

Review of Journal of Cardiovascular Magnetic Resonance (JCMR) 2015-2016 and transition of the JCMR office to Boston

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