The Prognostic Implications of Cardiovascular Magnetic Resonance

Flett, Andrew; Westwood, Mark; Davies, L. Ceri; Mathur, Anthony; Moon, James

doi:10.1161/circimaging.108.840975

Cited by 43 publications

(26 citation statements)

References 73 publications

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“…A growing body of evidence is pointing to the prognostic value of LGE in several clinical scenarios and suggests the potential for combining this information with that provided by myocardial perfusion and wall motion assessment during a stress CMR study. 39,40 In this regard, using CMR, Steel et al 31 reported the lowest annual event rates (<2%) for cardiac death or nonfatal MI in the group of patients with neither reversible PDs nor LGE. More recently, Bingham et al 21 found a very low annual cardiac mortality rate (≤0.4%) in patients contemporaneously showing normal perfusion, no LGE, normal aortic flow, and left ventricular function evaluated at CMR, emphasizing the great potential of this modality for assessing within a single examination complementary prognostic parameters.…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Value of Normal Stress Cardiac Magnetic Resonance in Patients With Known or Suspected Coronary Artery Disease

Gargiulo

Dellegrottaglie

Bruzzese

et al. 2013

Circ: Cardiovascular Imaging

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Background— Ischemia detection with stress cardiac magnetic resonance (CMR) is typically based on induction of either myocardial perfusion defect or wall motion abnormality. Single-center studies have shown the high value of stress CMR for risk stratification. The aim of this study was to define the prognostic value of stress CMR for prediction of adverse cardiac events in patients with known or suspected coronary artery disease. Methods and Results— Studies published between January 1985 and April 2012 were identified by database search. We included studies using stress CMR to evaluate subjects with known or suspected coronary artery disease and providing primary data on clinical outcomes of nonfatal myocardial infarction or cardiac death with a follow-up time ≥3 months. Total of 14 studies were finally included, recruiting 12 178 patients. The negative predictive value for nonfatal myocardial infarction and cardiac death of normal CMR was 98.12% (95% confidence interval, 97.26–98.83) during a weighted mean follow-up of 25.3 months, resulting in estimated event rate after a negative test equal to 1.88% (95% confidence interval, 1.17–2.74). The corresponding annualized event rate after a negative test was 1.03%. Comparable negative predictive values for major coronary events were obtained in studies considering the absence of inducible perfusion defect compared with those evaluating the absence of inducible wall motion abnormality (98.39% versus 97.31%, respectively; P =0.227 by meta-regression analysis). Conclusions— Stress CMR has a high negative predictive value for adverse cardiac events, and the absence of inducible perfusion defect or wall motion abnormality shows a similar ability to identify low-risk patients with known or suspected coronary artery disease.

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Section: Discussionmentioning

confidence: 99%

The Prognostic Value of Normal Stress Cardiac Magnetic Resonance in Patients With Known or Suspected Coronary Artery Disease

Gargiulo

Dellegrottaglie

Bruzzese

et al. 2013

Circ: Cardiovascular Imaging

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“…Diagnostic workup of dilated and hypertrophic CMPs was also frequently required in our series (respectively 9.2% and 8.7%) with an important contribution acknowledged to the exam (relevant and with impact on management in respectively 54% and 41% of cases) reflecting its role in the differential diagnosis between the various types of dilated and hypertrophic phenotypes of disease and its important prognostic implications [28][29][30].…”

Section: Clinical Indications and Impact On Patient's Managementmentioning

confidence: 93%

Italian registry of cardiac magnetic resonance

Francone¹,

Cesare²,

Cademartiri³

et al. 2014

European Journal of Radiology

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Objectives Forty sites were involved in this multicenter and multivendor registry, which sought to evaluate indications, spectrum of protocols, impact on clinical decision making and safety profile of cardiac magnetic resonance (CMR). Materials and methods Data were prospectively collected on a 6-month period and included 3376 patients (47.2 ± 19 years; range 1-92 years). Recruited centers were asked to complete a preliminary general report followed by a single form/patient. Referral physicians were not required to exhibit any specific certificate of competency in CMR imaging. Results Exams were performed with 1.5 T scanners in 96% of cases followed by 3 T (3%) and 1 T (1%) magnets and contrast was administered in 84% of cases. The majority of cases were performed for the workup of inflammatory heart disease/cardiomyopathies representing overall 55.7% of exams followed by the assessment of myocardial viability and acute infarction (respectively 6.9% and 5.9% of patients). In 49% of cases the final diagnosis provided was considered relevant and with impact on patient's clinical/therapeutic management. Safety evaluation revealed 30 (0.88%) clinical events, most of which due to patient's preexisting conditions. Radiological reporting was recorded in 73% of exams. Conclusions CMR is performed in a large number of centers in Italy with relevant impact on clinical decision making and high safety profile. © 2013 Elsevier Ireland Ltd

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“…Whereas the relatively low event rate precluded measuring a statistical difference between the LGE-positive and LGE-negative groups, the trend reinforces the findings in other large-scale studies of the very strong adverse prognostic value of abnormal LGE on CMR. 9,10 Friedreich ataxia is the prevalent cause of hereditary ataxia and accounts for about 50% of cases of hereditary ataxia. 1 Nearly all patients who meet the genetic and neurologic criteria for FA have evidence of cardiac involvement.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, we have identif ied PICP as a marker of progressive LV dilation. This phenotype increases the risk of heart failure and arrhythmias, 9 the chief clinical complications of FA cardiomyopathy. Given the urgent need for better Data are presented as mean ± SE.…”

Section: Discussionmentioning

confidence: 99%

Serum versus Imaging Biomarkers in Friedreich Ataxia to Indicate Left Ventricular Remodeling and Outcomes

Mehta¹,

Chacko²,

Jin³

et al. 2016

Texas Heart Institute Journal

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Patients with Friedreich ataxia typically die of cardiomyopathy, marked by myocardial fibrosis and abnormal left ventricular (LV) geometry. We measured procollagen I carboxyterminal propeptide (PICP), a serum biomarker of collagen production, and characterized genotypes, phenotypes, and outcomes in these patients. Twenty-nine patients with Friedreich ataxia (mean age, 34.2 ± 2.2 yr) and 29 healthy subjects (mean age, 32.5 ± 1.1 yr) underwent serum PICP measurements. Patients underwent cardiac magnetic resonance imaging and outcome evaluations at baseline and 12 months. Baseline PICP values were significantly higher in the patients than in the control group (1,048 ± 77 vs 614 ± 23 ng/mL; P <0.001); severity of genetic abnormality did not indicate severity of PICP elevation. Higher PICP levels corresponded to greater LV concentric remodeling only at baseline (r=0.37, P <0.05). Higher baseline PICP strongly indicated subsequent increases in LV end-diastolic volume (r=0.52, P=0.02). The PICP levels did not distinguish between 14 patients with evident myocardial fibrosis identified through positive late gadolinium enhancement and 15 who had no enhancement (1,067 ± 125 vs 1,030 ± 98 ng/mL; P=0.82). At 12 months, cardiac events had occurred in 3 of 14 fibrosis-positive and none of 15 fibrosis-negative patients (P=0.1); their baseline PICP levels were similar. We conclude that PICP, a serum marker of collagen synthesis, is elevated in Friedreich ataxia and indicates baseline abnormal LV geometry and subsequent dilation. Cardiac magnetic resonance and PICP warrant consideration as complementary biomarkers in therapeutic trials of Friedreich ataxia cardiomyopathy.

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The Prognostic Implications of Cardiovascular Magnetic Resonance

Cited by 43 publications

References 73 publications

The Prognostic Value of Normal Stress Cardiac Magnetic Resonance in Patients With Known or Suspected Coronary Artery Disease

The Prognostic Value of Normal Stress Cardiac Magnetic Resonance in Patients With Known or Suspected Coronary Artery Disease

Italian registry of cardiac magnetic resonance

Serum versus Imaging Biomarkers in Friedreich Ataxia to Indicate Left Ventricular Remodeling and Outcomes

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