PMID- 21097819 OWN - NLM STAT- MEDLINE DCOM- 20110629 LR - 20151119 IS - 1468-201X (Electronic) IS - 1355-6037 (Linking) VI - 97 IP - 9 DP - 2011 May TI - 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. PG - 727-32 LID - 10.1136/hrt.2010.205542 [doi] AB - OBJECTIVE: Owing to its variable clinical course, risk stratification is of paramount importance in non-ischaemic dilated cardiomyopathy (DCM). The goal of this study was to investigate the long-term prognostic significance of late gadolinium enhancement (LGE) as detected by contrast-enhanced cardiovascular magnetic resonance (CE-CMR) in patients with DCM. DESIGN: Observational cohort study. Setting University hospital. PATIENTS: 184 consecutive patients with DCM. MEASUREMENTS: CE-CMR was performed on a 1.5 T clinical scanner. Presence, extent and patterns of LGE were determined by two independent observers. OUTCOME MEASURES: Patients were followed for the composite end point of cardiac death, hospitalisation for decompensated heart failure, or appropriate implantable cardioverter defibrillator discharge for a mean+/-SEM of 685+/-30 days. RESULTS: LGE was detected in 72/184 patients (39%) and was associated with a lower left ventricular (LV) ejection fraction (31% (20.9-42.2%) vs 44% (33.1-50.9%), p<0.001), higher LV end-diastolic volume index (133 (116-161) ml/m(2) vs 109 (92.7-137.6) ml/m(2), p<0.001) and higher LV mass (80 (67.1-94.8) g/m(2) vs 65.8 (55.2-82.9) g/m(2), p<0.001). Patients in whom LGE was present were more likely to experience the composite end point (15/72 vs 6/112, p=0.002). Receiver operating characteristic curve analysis revealed a LGE of >4.4% of LV mass as optimal discriminator for the composite end point. When entered into multivariate Cox regression analysis, LGE retained its independent predictive value, yielding an associated HR of 3.4 (95% CI 1.26 to 9). CONCLUSION: 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. FAU - Lehrke, Stephanie AU - Lehrke S AD - Abteilung Innere Medizin III, Medizinische Klinik, Universitatsklinikum Heidelberg, Heidelberg, Germany. stephanie.lehrke@med.uni-heidelberg.de FAU - Lossnitzer, Dirk AU - Lossnitzer D FAU - Schob, Michael AU - Schob M FAU - Steen, Henning AU - Steen H FAU - Merten, Constanze AU - Merten C FAU - Kemmling, Helmut AU - Kemmling H FAU - Pribe, Regina AU - Pribe R FAU - Ehlermann, Philipp AU - Ehlermann P FAU - Zugck, Christian AU - Zugck C FAU - Korosoglou, Grigorios AU - Korosoglou G FAU - Giannitsis, Evangelos AU - Giannitsis E FAU - Katus, Hugo A AU - Katus HA LA - eng PT - Journal Article DEP - 20101120 PL - England TA - Heart JT - Heart (British Cardiac Society) JID - 9602087 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) RN - K2I13DR72L (Gadolinium DTPA) SB - IM MH - Cardiomyopathy, Dilated/mortality/*pathology MH - Chronic Disease MH - Cohort Studies MH - *Contrast Media MH - Death, Sudden, Cardiac/pathology MH - Female MH - *Gadolinium MH - *Gadolinium DTPA MH - Heart Failure/mortality/*pathology MH - Hospitalization/statistics & numerical data MH - Humans MH - Kaplan-Meier Estimate MH - Magnetic Resonance Angiography/methods MH - Male MH - Middle Aged MH - Prognosis EDAT- 2010/11/26 06:00 MHDA- 2011/06/30 06:00 CRDT- 2010/11/25 06:00 PHST- 2010/11/25 06:00 [entrez] PHST- 2010/11/26 06:00 [pubmed] PHST- 2011/06/30 06:00 [medline] AID - hrt.2010.205542 [pii] AID - 10.1136/hrt.2010.205542 [doi] PST - ppublish SO - Heart. 2011 May;97(9):727-32. doi: 10.1136/hrt.2010.205542. Epub 2010 Nov 20.