PMID- 26358695
OWN - NLM
STAT- MEDLINE
DCOM- 20171102
LR  - 20171102
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Linking)
VI  - 17
IP  - 7
DP  - 2016 Jul
TI  - Differences in the prognostic relevance of myocardial ischaemia and scar by 
      cardiac magnetic resonance in patients with and without diabetes mellitus.
PG  - 812-20
LID - 10.1093/ehjci/jev220 [doi]
AB  - AIMS: To evaluate the prognostic significance of myocardial ischaemia and scar in 
      patients with and without diabetes mellitus (DM) who undergo dobutamine stress 
      cardiac magnetic resonance (DCMR) and late gadolinium enhancement (LGE) imaging 
      for known and suspected coronary artery diseases (CADs). METHODS AND RESULTS: A 
      total of 1969 consecutive patients [age 63 +/- 12 years, 29% female, left 
      ventricular ejection fraction = 59 +/- 12%] referred for a cardiac magnetic 
      resonance (CMR) examination including DCMR and LGE with the suspicion of CAD or 
      progression of CAD in three tertiary cardiac centres were analysed. Cardiac death 
      and nonfatal myocardial infarction (MI) were registered as hard cardiac events. 
      Patients with a revascularization procedure within the first 3 months after CMR 
      were censored at the time of 'early' revascularization. Patients were followed 
      for 3.2 +/- 1.5 years (median 2.9, interquartile range 2-4.3 years). In total, 90 
      (4.6%) cardiac deaths and MI were registered. Among them, 328 patients (16.6%) 
      had diabetes. The proportion of dobutamine-induced wall motion abnormalities 
      (DWMA) and LGE was higher in patients with DM when compared with those without DM 
      (27 vs. 19% and 53.6 vs. 41.2%, respectively, P < 0.001 for both for 
      proportions). Both DWMA and LGE were independent predictors of cardiac death and 
      MI in patients without DM (HR for DWMA 8, CI 4.5-14.3, HR for LGE 2.1, CI 
      1.1-4.1) and with DM (HR for DWMA 8.6, CI 3.5-21, HR for LGE 4.5, CI 1.5-13.1). 
      Tests for interaction showed that LGE more strongly influences prognosis in 
      patients with than in those without DM (P = 0.03 for interaction), whereas the 
      presence of DWMA is related to similarly poor outcomes in patients with and 
      without DM (P = NS). CONCLUSION: Myocardial scar by LGE is a hallmark of markedly 
      poorer outcome in patients with DM, while the presence of inducible myocardial 
      ischaemia seems to be predictive both in patients with and without DM. Both 
      markers surpass the predictive value of conventional atherogenic risk factors 
      both in patients with and without DM.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author 2015. For permissions please email: journals.permissions@oup.com.
FAU - Giusca, S
AU  - Giusca S
AD  - Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 
      Heidelberg 69120, Germany.
FAU - Kelle, S
AU  - Kelle S
AD  - Department of Internal Medicine/Cardiology, German Heart Institute Berlin, 
      Berlin, Germany.
FAU - Nagel, E
AU  - Nagel E
AD  - Division of Imaging Sciences, Kings College London, London, UK.
FAU - Buss, S J
AU  - Buss SJ
AD  - Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 
      Heidelberg 69120, Germany.
FAU - Voss, A
AU  - Voss A
AD  - Department of Psychology, University of Heidelberg, Heidelberg, Germany.
FAU - Puntmann, V
AU  - Puntmann V
AD  - Division of Imaging Sciences, Kings College London, London, UK.
FAU - Fleck, E
AU  - Fleck E
AD  - Department of Internal Medicine/Cardiology, German Heart Institute Berlin, 
      Berlin, Germany.
FAU - Katus, H A
AU  - Katus HA
AD  - Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 
      Heidelberg 69120, Germany.
FAU - Korosoglou, G
AU  - Korosoglou G
AD  - Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 
      Heidelberg 69120, Germany gkorosoglou@hotmail.com.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20150910
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Aged
MH  - Analysis of Variance
MH  - Cicatrix/diagnostic imaging/epidemiology/pathology
MH  - Cohort Studies
MH  - Coronary Disease/diagnostic imaging/epidemiology/physiopathology
MH  - Diabetes Mellitus/diagnosis/*epidemiology
MH  - Disease Progression
MH  - *Echocardiography, Stress
MH  - Female
MH  - Gadolinium
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Ischemia/*diagnostic imaging/*epidemiology/physiopathology
MH  - Myocardium/pathology
MH  - Observer Variation
MH  - Prognosis
MH  - Radiographic Image Enhancement/methods
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
OTO - NOTNLM
OT  - cardiovascular magnetic resonance imaging
OT  - coronary artery disease
OT  - diabetes mellitus
OT  - late gadolinium enhancement
OT  - myocardial scar
OT  - outcome
OT  - prognosis
EDAT- 2015/09/12 06:00
MHDA- 2017/11/03 06:00
CRDT- 2015/09/12 06:00
PHST- 2015/04/20 00:00 [received]
PHST- 2015/08/10 00:00 [accepted]
PHST- 2015/09/12 06:00 [entrez]
PHST- 2015/09/12 06:00 [pubmed]
PHST- 2017/11/03 06:00 [medline]
AID - jev220 [pii]
AID - 10.1093/ehjci/jev220 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2016 Jul;17(7):812-20. doi: 10.1093/ehjci/jev220. 
      Epub 2015 Sep 10.