Use of cardiovascular magnetic resonance for risk stratification in chronic heart failure: prognostic value of late gadolinium enhancement in patients with non-ischaemic dilated cardiomyopathy

Lehrke, Stephanie; Loßnitzer, Dirk; Schöb, Michael; Steen, Henning; Merten, Constanze; Kemmling, Helmut; Pribe, Regina; Ehlermann, Philipp; Zugck, Christian; Korosoglou, Grigorios; Giannitsis, Evangelos; Katus, Hugo A.

doi:10.1136/hrt.2010.205542

Cited by 201 publications

(142 citation statements)

References 32 publications

Supporting

Mentioning

121

Contrasting

Unclassified

Order By: Relevance

“…Of these, 21 were excluded because they did not meet inclusion criteria. Three were excluded [1][2][3] because their data were included in more recent publications. [4][5][6] A total of 29 studies were finally included in the metaanalysis ( Figure 1).…”

Section: Search Results and Study Selectionmentioning

confidence: 99%

Late Gadolinium Enhancement and the Risk for Ventricular Arrhythmias or Sudden Death in Dilated Cardiomyopathy

Marco

Anguera

Schmitt³

et al. 2017

JACC: Heart Failure

311

188

View full text Add to dashboard Cite

Di Marco, A. et al. (2017) Late gadolinium enhancement and the risk for ventricular arrhythmias or sudden death in dilated cardiomyopathy: systematic review and meta-analysis. JACC: Heart Failure, 5(1), pp. 28-38. (doi:10.1016/j.jchf.2016.09.017) This is the author's final accepted version.There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.http://eprints.gla.ac.uk/133553/ Background: Risk stratification for SCD in DCM needs to be improved.

show abstract

Section: Search Results and Study Selectionmentioning

confidence: 99%

Late Gadolinium Enhancement and the Risk for Ventricular Arrhythmias or Sudden Death in Dilated Cardiomyopathy

Marco

Anguera

Schmitt³

et al. 2017

JACC: Heart Failure

311

188

View full text Add to dashboard Cite

show abstract

“…88 Myocardial fibrosis in DCM patients has been identified as an independent predictor of adverse clinical outcomes. 89, 90 The presence of midwall fibrosis is an independent predictor of all-cause mortality and cardiovascular hospitalization, independent of ventricular remodeling and EF. 70, 91 In addition, midwall fibrosis predicts sudden cardiac death and ventricular tachyarrhythmia, especially if the conduction system is involved, suggesting a potential role for CMR in the risk stratification of patients with DCM who may need device therapy.…”

Section: Myocardial Fibrosis In Primary Lvhmentioning

confidence: 99%

From Left Ventricular Hypertrophy to Dysfunction and Failure

Lazzeroni

Rimoldi

Camici

2016

Circ J

124

View full text Add to dashboard Cite

Left ventricular hypertrophy (LVH) is growth in left ventricular mass caused by increased cardiomyocyte size. LVH can be a physiological adaptation to strenuous physical exercise, as in athletes, or it can be a pathological condition, which is either genetic or secondary to LV overload. Physiological LVH is usually benign and regresses upon reduction/cessation of physical activity. Pathological LVH is a compensatory phenomenon, which eventually may become maladaptive and evolve towards progressive LV dysfunction and heart failure (HF). Both interstitial and replacement fibrosis play a major role in the progressive decompensation of the hypertrophied LV. Coronary microvascular dysfunction (CMD) and myocardial ischemia, which have been demonstrated in most forms of pathological LVH, have an important pathogenetic role in the formation of replacement fibrosis and both contribute to the evolution towards LV dysfunction and HF. Noninvasive imaging allows detection of myocardial fibrosis and CMD, thus providing unique information for the stratification of patients with LVH. DCM is generally caused by viral/bacterial myocarditis, exposure to cardiotoxic substances or is a manifestation of a systemic disease. Before cell death and fibrotic repair occur, multiple factors contribute to contractile dysfunction, including abnormalities in sarcolemmal integrity, energy production, calcium handling and force transmission. 10 Both systolic and diastolic dysfunction worsen with time and EF is progressively reduced, with symptoms and signs of HF. Secondary LVHCardiomyocyte hypertrophy is the primary mechanism by which the heart counteracts a protracted increase in stress (or load) on the ventricular wall. 11 According to Laplace's law, 12 wall stress is directly related to LV cavity size and intracavitary pressure and inversely related to wall thickness. Thus, wall thickening will counteract, at least in part, the increased stress and oxygen demand caused by pressure or volume overload, although, in the long run, this compensatory mechanism may become maladaptive. On the other hand, several other nonhemodynamic factors, including activation of the adrenergic and renin-angiotensin-aldosterone (RAAS) systems, release of growth factors and cytokines, contribute to the development of LVH. 13,14 Pressure Overload In most cases, pressure overload manifests as arterial hypertension (AH) or aortic stenosis (AS).Hypertensive Heart The most common condition associated with an increase in cardiac afterload and wall stress is AH. 15 Approximately 20-60% of patients with uncomplicated AH have evidence of increased LVM on echocardiography. 16 LVM can increase from wall thickening, chamber dilatation or both. Wall thickening occurs more commonly in response to pressure overload whereas chamber dilation occurs more commonly in response to volume overload. Although LV wall thickness is more closely related to systemic diastolic blood pressure (concentric hypertrophy), reflecting pure pressure load caused by increased systemic vascular resistance...

show abstract

“…20 Interestingly, in our patients with DCM, no regional scarring-known to be associated with an adverse outcome and an increased rate of arrhythmogenic events-was detected by CMR. 7,8 Future CMR studies are needed to demonstrate whether not only the absence or presence of focal LGE but also the presence of diffuse myocardial fibrosis (T 1 mapping) may identify those DCM patients with more adverse outcomes and increased risk of arrhythmia. 21 A wide spectrum of other cardiac diseases has been identified in the past to be associated with VAs.…”

Section: Cardiac Conditions and Morphological Substrate Of Arrhythmiamentioning

confidence: 99%

“…4,5 A number of studies have been undertaken, or are ongoing, to further elucidate the added value of CMR in patients with known cardiac conditions, to improve risk stratification for VA and to optimize therapy. 1,[6][7][8] However, little is known to date regarding the added value of CMR for detection of an arrhythmogenic substrate or underlying cardiac condition in patients who present with VAs without known cardiac disease.…”

mentioning

confidence: 99%

Prevalence and clinical relevance of the morphological substrate of ventricular arrhythmias in patients without known cardiac conditions detected by cardiovascular MR

Weisser-Thomas¹,

Ferrari²,

Lakghomi³

et al. 2014

BJR|case reports

View full text Add to dashboard Cite

Use of cardiovascular magnetic resonance for risk stratification in chronic heart failure: prognostic value of late gadolinium enhancement in patients with non-ischaemic dilated cardiomyopathy

Abstract: The presence of LGE in this large DCM patient cohort is associated with pronounced LV remodelling, functional impairment and an adverse outcome. Further research is necessary to determine whether these findings will aid the clinical management of DCM patients.

Cited by 201 publications

References 32 publications

Late Gadolinium Enhancement and the Risk for Ventricular Arrhythmias or Sudden Death in Dilated Cardiomyopathy

Late Gadolinium Enhancement and the Risk for Ventricular Arrhythmias or Sudden Death in Dilated Cardiomyopathy

From Left Ventricular Hypertrophy to Dysfunction and Failure

Prevalence and clinical relevance of the morphological substrate of ventricular arrhythmias in patients without known cardiac conditions detected by cardiovascular MR

Contact Info

Product

Resources

About