PMID- 23437315 OWN - NLM STAT- MEDLINE DCOM- 20130823 LR - 20211021 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 8 IP - 2 DP - 2013 TI - Prognostic value of contrast-enhanced cardiac magnetic resonance imaging in patients with newly diagnosed non-ischemic cardiomyopathy: cohort study. PG - e57077 LID - 10.1371/journal.pone.0057077 [doi] LID - e57077 AB - BACKGROUND: Owing to its variable course from asymptomatic cases to sudden death risk stratification is of paramount importance in newly diagnosed non-ischemic cardiomyopathy. We tested whether late gadolinium enhancement (LGE) assessed by cardiac magnetic resonance (CMR) imaging is a prognostic marker in consecutive patients with newly diagnosed non-ischemic cardiomyopathy. METHODS: We enrolled 185 patients who presented for evaluation of newly diagnosed non-ischemic cardiomyopathy. Coronary artery disease was excluded by coronary angiography. Following risk markers were additionally assessed: NYHA functional class (>/=II), brain natriuretic peptide (>100 ng/l), troponin I (TnI, >/=0.03 microg/l), left ventricular ejection fraction (LVEF, 55 mm) and QRS duration (>98 ms). Endpoint of the study was the composite of all-cause mortality, heart transplantation, aborted sudden death, sustained ventricular tachycardia or hospitalization due to decompensated heart failure within three years of follow-up. RESULTS: During median follow-up of 21 months, 54 patients (29.2%) reached the composite endpoint. Ninety-four of the 185 patients (50.8%) were judged LGE-positive. Prognosis of LGE-positive patients was significantly worse than that of LGE-negative patients (cumulative 3-year event rates of 67.4% in LGE-positive and 27.2% in LGE-negative patients, respectively; p = 0.021). However, in multivariable analysis, presence of LGE was not an independent predictor of outcome. Only LVEF /=0.03 microg/l were independent risk predictors of the composite endpoint yielding relative risks of 3.9 (95% CI 1.9-8.1; p<0.0001) and 2.2 (95% CI 1.2-4.0; p = 0.014), respectively. CONCLUSIONS: In consecutive patients presenting with newly diagnosed non-ischemic cardiomyopathy, LGE-positive patients had worse prognosis. However, only traditional risk parameters like left ventricular performance and cardiac biomarkers but not presence of LGE were independent risk predictors. FAU - Muller, Karin A L AU - Muller KA AD - Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard Karls University, Tubingen, Germany. FAU - Muller, Iris AU - Muller I FAU - Kramer, Ulrich AU - Kramer U FAU - Kandolf, Reinhard AU - Kandolf R FAU - Gawaz, Meinrad AU - Gawaz M FAU - Bauer, Axel AU - Bauer A FAU - Zuern, Christine S AU - Zuern CS LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20130220 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Adult MH - Aged MH - Cardiomyopathies/*diagnosis MH - *Contrast Media MH - Female MH - Follow-Up Studies MH - *Gadolinium MH - Humans MH - *Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Prognosis MH - Risk Factors PMC - PMC3577793 COIS- Competing Interests: The authors have declared that no competing interests exist. EDAT- 2013/02/26 06:00 MHDA- 2013/08/24 06:00 PMCR- 2013/02/20 CRDT- 2013/02/26 06:00 PHST- 2012/09/10 00:00 [received] PHST- 2013/01/17 00:00 [accepted] PHST- 2013/02/26 06:00 [entrez] PHST- 2013/02/26 06:00 [pubmed] PHST- 2013/08/24 06:00 [medline] PHST- 2013/02/20 00:00 [pmc-release] AID - PONE-D-12-27406 [pii] AID - 10.1371/journal.pone.0057077 [doi] PST - ppublish SO - PLoS One. 2013;8(2):e57077. doi: 10.1371/journal.pone.0057077. Epub 2013 Feb 20.