PMID- 29898740 OWN - NLM STAT- MEDLINE DCOM- 20190314 LR - 20240117 IS - 1532-429X (Electronic) IS - 1097-6647 (Print) IS - 1097-6647 (Linking) VI - 20 IP - 1 DP - 2018 Jun 14 TI - Prognostic value of myocardial strain and late gadolinium enhancement on cardiovascular magnetic resonance imaging in patients with idiopathic dilated cardiomyopathy with moderate to severely reduced ejection fraction. PG - 36 LID - 10.1186/s12968-018-0466-7 [doi] LID - 36 AB - BACKGROUND: It has been reported that left ventricular (LV) myocardial strain and late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) imaging have prognostic value in patients with heart failure (HF). However, previous studies included patients with various systolic functions. This study aimed to investigate the prognostic value of LV myocardial strain and LGE on CMR imaging in patients with idiopathic dilated cardiomyopathy (DCM) with reduced ejection fraction (EF < 40%). METHODS: From a prospectively followed cohort who underwent CMR between November 2008 and December 2015, subjects with LV EF < 40% and a diagnosis of idiopathic DCM were eligible for this study. The CMR images were analyzed for LV and right ventricular (RV) function, presence and extent of LGE, and LV myocardial strain. The primary outcome was a composite of all-cause death and heart transplantation. The secondary outcome was hospitalization for HF. RESULTS: A total of 172 patients were included, in whom mean LV EF was 23.7 +/- 7.9% (EF 30-40% n = 47; EF < 30% n = 125). During a median follow-up of 47 months, the primary outcome occurred in 43 patients (16 heart transplantations, 29 all-cause deaths), and there were 41 hospitalizations for HF. Univariate Cox proportional hazard regression analysis showed that mean arterial pressure, serum sodium concentration, log of plasma NT-proBNP level, and presence of LGE (HR 2.277, 95% CI: 1.221-4.246) were significantly associated with the primary outcome. However, LV strain had no significant association (HR 1.048, 95% CI: 0.945-1.163). Multivariable analysis showed that presence of LGE (HR 4.73, 95% CI: 1.11-20.12) and serum sodium (HR 0.823, 95% CI: 0.762-0.887) were independently associated with the primary outcome. CONCLUSIONS: LGE in CMR imaging was a good predictor of adverse outcomes for patients with idiopathic DCM and reduced EF. Identification of LGE could thus improve risk stratification in high-risk patients. LV strain had no significant prognostic value in patients with moderate to severe systolic dysfunction. FAU - Pi, Seung-Hoon AU - Pi SH AD - Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. FAU - Kim, Sung Mok AU - Kim SM AD - Department of Radiology, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. FAU - Choi, Jin-Oh AU - Choi JO AUID- ORCID: 0000-0002-2441-2267 AD - Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. choijean5@gmail.com. FAU - Kim, Eun Kyoung AU - Kim EK AD - Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. FAU - Chang, Sung-A AU - Chang SA AD - Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. FAU - Choe, Yeon Hyeon AU - Choe YH AD - Department of Radiology, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. FAU - Lee, Sang-Chol AU - Lee SC AD - Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. FAU - Jeon, Eun-Seok AU - Jeon ES AD - Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. LA - eng PT - Journal Article DEP - 20180614 PL - England TA - J Cardiovasc Magn Reson JT - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance JID - 9815616 RN - 0 (Contrast Media) RN - 0 (Organometallic Compounds) RN - 1BJ477IO2L (gadobutrol) SB - IM MH - Adult MH - Aged MH - Biomechanical Phenomena MH - Cardiomyopathy, Dilated/*diagnostic imaging/mortality/physiopathology/surgery MH - Contrast Media/*administration & dosage MH - Female MH - Heart Failure/*diagnostic imaging/mortality/physiopathology/surgery MH - Heart Transplantation MH - Hospitalization MH - Humans MH - *Magnetic Resonance Imaging, Cine MH - Male MH - Middle Aged MH - *Myocardial Contraction MH - Organometallic Compounds/*administration & dosage MH - Predictive Value of Tests MH - Prognosis MH - Prospective Studies MH - Reproducibility of Results MH - Risk Factors MH - *Stroke Volume MH - Ventricular Dysfunction, Left/*diagnostic imaging/mortality/physiopathology/surgery MH - *Ventricular Function, Left MH - Ventricular Function, Right PMC - PMC6001169 OTO - NOTNLM OT - Cardiovascular magnetic resonance imaging OT - Idiopathic dilated cardiomyopathy OT - Late gadolinium enhancement OT - Myocardial strain OT - Prognosis COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Ethical approval was obtained by the local Institutional Review Board of Samsung Medical Center (IRB File No. SMC 2017-01-104). All study subjects agreed to provide information for CMR cohort registry and written informed consent for this study was waived from our Institutional Review Board. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/06/15 06:00 MHDA- 2019/03/15 06:00 PMCR- 2018/06/14 CRDT- 2018/06/15 06:00 PHST- 2017/10/11 00:00 [received] PHST- 2018/05/25 00:00 [accepted] PHST- 2018/06/15 06:00 [entrez] PHST- 2018/06/15 06:00 [pubmed] PHST- 2019/03/15 06:00 [medline] PHST- 2018/06/14 00:00 [pmc-release] AID - S1097-6647(23)00573-2 [pii] AID - 466 [pii] AID - 10.1186/s12968-018-0466-7 [doi] PST - epublish SO - J Cardiovasc Magn Reson. 2018 Jun 14;20(1):36. doi: 10.1186/s12968-018-0466-7.