PMID- 29107357 OWN - NLM STAT- MEDLINE DCOM- 20180713 LR - 20180713 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 250 DP - 2018 Jan 1 TI - Late gadolinium enhancement as a predictor of functional recovery, need for defibrillator implantation and prognosis in non-ischemic dilated cardiomyopathy. PG - 195-200 LID - S0167-5273(17)34163-3 [pii] LID - 10.1016/j.ijcard.2017.10.043 [doi] AB - BACKGROUND: Aim of the study was to investigate whether late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) predict reverse remodeling (RR) in non-ischemic dilated cardiomyopathy (NIDCM). METHODS: Seventy-one NIDCM patients (age 57+/-14years, 43 males, median left ventricular ejection fraction [LVEF] 35%, [interquartile range 27-41%]) with two CMR scans within 5years were included. RR was defined as >/=10% reduction in left ventricular (LV) end-diastolic volume and >/=10% LVEF increase. The end-point was a composite of all-cause death, cardiovascular hospitalization or appropriate defibrillator discharge. LGE was assessed both visually and as percentage of LV mass (LGE%). RESULTS: LGE was present in 42 patients (59%). During the interval between the 2 CMR scans (median 28 [15-44]months), 22 patients (31%) displayed RR. LGE absence predicted RR irrespectively of baseline LV volumes and LVEF. Over a median 42[15-73]-month follow-up, the endpoint occurred in 36 patients (51%). LGE absence was associated with better prognosis (P=0.043), with best quantitative LGE cut-point <7% at ROC analysis (P=0.017), but RR was the strongest prognostic predictor. Among 35 patients with baseline LVEF <35%, 25 (69%) crossed the 35% LVEF threshold. Both LGE absence and quantitative LGE <7% were associated with crossing of the 35% LVEF threshold for defibrillator implantation; patients with either LGE or quantitative LGE>/=7% had a worse prognosis. CONCLUSIONS: In NIDCM, the absence of LGE at baseline CMR is associated with RR. When baseline LVEF is <35%, LGE absence is associated with more frequent crossing of the 35% LVEF threshold for defibrillator implantation. CI - Copyright (c) 2017 Elsevier Ireland Ltd. All rights reserved. FAU - Barison, Andrea AU - Barison A AD - Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Scuola Superiore Sant'Anna, Pisa, Italy. Electronic address: dr.andrea.barison@gmail.com. FAU - Aimo, Alberto AU - Aimo A AD - Scuola Superiore Sant'Anna, Pisa, Italy. FAU - Ortalda, Alessandro AU - Ortalda A AD - Vita salute University and San Raffaele Hospital, Milan, Italy. FAU - Todiere, Giancarlo AU - Todiere G AD - Fondazione Toscana Gabriele Monasterio, Pisa, Italy. FAU - Grigoratos, Chrysanthos AU - Grigoratos C AD - Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Scuola Superiore Sant'Anna, Pisa, Italy. FAU - Passino, Claudio AU - Passino C AD - Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Scuola Superiore Sant'Anna, Pisa, Italy. FAU - Camici, Paolo G AU - Camici PG AD - Vita salute University and San Raffaele Hospital, Milan, Italy. FAU - Aquaro, Giovanni D AU - Aquaro GD AD - Fondazione Toscana Gabriele Monasterio, Pisa, Italy. FAU - Emdin, Michele AU - Emdin M AD - Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Scuola Superiore Sant'Anna, Pisa, Italy. LA - eng PT - Journal Article DEP - 20171019 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Contrast Media) RN - 84F6U3J2R6 (gadodiamide) RN - AU0V1LM3JT (Gadolinium) RN - K2I13DR72L (Gadolinium DTPA) SB - IM MH - Adult MH - Aged MH - Cardiomyopathy, Dilated/*diagnostic imaging/physiopathology/*surgery MH - *Contrast Media/administration & dosage MH - Defibrillators, Implantable/*trends MH - Female MH - Follow-Up Studies MH - Gadolinium/administration & dosage MH - *Gadolinium DTPA/administration & dosage MH - Humans MH - Magnetic Resonance Imaging, Cine/methods MH - Male MH - Middle Aged MH - Prognosis MH - Recovery of Function/*physiology MH - Retrospective Studies OTO - NOTNLM OT - Cardiac magnetic resonance OT - Heart failure OT - Late gadolinium enhancement OT - Prognosis OT - Reverse remodeling EDAT- 2017/11/07 06:00 MHDA- 2018/07/14 06:00 CRDT- 2017/11/07 06:00 PHST- 2017/07/09 00:00 [received] PHST- 2017/10/02 00:00 [revised] PHST- 2017/10/13 00:00 [accepted] PHST- 2017/11/07 06:00 [pubmed] PHST- 2018/07/14 06:00 [medline] PHST- 2017/11/07 06:00 [entrez] AID - S0167-5273(17)34163-3 [pii] AID - 10.1016/j.ijcard.2017.10.043 [doi] PST - ppublish SO - Int J Cardiol. 2018 Jan 1;250:195-200. doi: 10.1016/j.ijcard.2017.10.043. Epub 2017 Oct 19.