PMID- 30485353
OWN - NLM
STAT- MEDLINE
DCOM- 20190501
LR  - 20200309
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 13
IP  - 11
DP  - 2018
TI  - Prognostic implications of late gadolinium enhancement at the right ventricular 
      insertion point in patients with non-ischemic dilated cardiomyopathy: A 
      multicenter retrospective cohort study.
PG  - e0208100
LID - 10.1371/journal.pone.0208100 [doi]
LID - e0208100
AB  - INTRODUCTION: The presence of late gadolinium enhancement (LGE) at the right 
      ventricular insertion point (RVIP) on cardiac magnetic resonance (CMR) is 
      generally believed to be nonspecific, but the clinical implication of this unique 
      LGE pattern in patients with non-ischemic dilated cardiomyopathy (NICM) has not 
      been elucidated. OBJECTIVES: We investigated the prognostic significance of 
      RVIP-LGE in NICM patients. METHODS: A total of 360 consecutive NICM patients 
      referred for CMR (102 with no LGE, 50 with RVIP-LGE, 121 with left ventricular 
      [LV]-LGE, and 87 with both an LV and RVIP-LGE) were studied. The primary endpoint 
      was a composite of the all-cause death, hospitalization due to worsening of heart 
      failure, and major arrhythmic events. RESULTS: During a mean follow-up of 45.2 +/- 
      36.5 months, 149 (41.4%) patients (22 [21.6%] no LGE vs. 16 [32.0%] RVIP-LGE vs. 
      62 [51.2%] LV-LGE vs. 49 [56.3%] both LV and RVIP-LGE, P < 0.0001) reached the 
      primary endpoint. A Kaplan Meier curve demonstrated that RVIP-LGE patients had an 
      intermediate trend of an event free survival rate for the composite endpoint 
      (log-rank P < 0.0001). In a multivariable Cox regression model, LV-LGE (P = 
      0.008) and both LV and RVIP-LGE (P = 0.003) were significantly associated with a 
      worse outcome, whereas RVIP-LGE was not (P = 0.101). In addition, RVIP-LGE 
      patients (n = 32) had a more favorable outcome compared to LV-LGE patients (n = 
      32) even after matching the extent of the LGE (median 3.4% [interquartile range, 
      3.1-3.8], 8 [25.0%] RVIP-LGE vs. 20 [62.5%] LV-LGE, P = 0.002). CONCLUSIONS: LGE 
      confined to the RVIP among NICM patients did not significantly increase the risk 
      of adverse cardiac events, and also showed a better outcome than the same extent 
      of LGE located in the LV. Identification of this unique LGE distribution may help 
      refine the current risk stratification.
FAU - Yi, Jeong-Eun
AU  - Yi JE
AUID- ORCID: 0000-0003-2614-6983
AD  - Department of Cardiology, Ewha Womans University College of Medicine, Seoul, 
      Republic of Korea.
FAU - Park, Junbeom
AU  - Park J
AD  - Department of Cardiology, Ewha Womans University College of Medicine, Seoul, 
      Republic of Korea.
FAU - Lee, Hye-Jeong
AU  - Lee HJ
AD  - Department of Radiology, Research Institute of Radiological Science, Yonsei 
      University College of Medicine, Seoul, Korea.
FAU - Shin, Dong Geum
AU  - Shin DG
AD  - Yonsei University Health System, Yonsei Cardiovascular Hospital, Yonsei 
      University College of Medicine, Seoul, Republic of Korea.
FAU - Kim, Yookyung
AU  - Kim Y
AD  - Department of Radiology, College of Medicine, Ewha Womans University School of 
      Medicine, Seoul, Republic of Korea.
FAU - Kim, Minsuk
AU  - Kim M
AD  - Department of Pharmacology, School of Medicine, Ewha Womans University, Seoul, 
      Republic of Korea.
FAU - Kwon, Kihwan
AU  - Kwon K
AD  - Department of Cardiology, Ewha Womans University College of Medicine, Seoul, 
      Republic of Korea.
FAU - Pyun, Wook Bum
AU  - Pyun WB
AUID- ORCID: 0000-0002-6377-0411
AD  - Department of Cardiology, Ewha Womans University College of Medicine, Seoul, 
      Republic of Korea.
FAU - Kim, Young Jin
AU  - Kim YJ
AUID- ORCID: 0000-0002-6235-6550
AD  - Department of Radiology, Research Institute of Radiological Science, Yonsei 
      University College of Medicine, Seoul, Korea.
FAU - Joung, Boyoung
AU  - Joung B
AUID- ORCID: 0000-0001-9036-7225
AD  - Yonsei University Health System, Yonsei Cardiovascular Hospital, Yonsei 
      University College of Medicine, Seoul, Republic of Korea.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20181128
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Cardiomyopathy, Dilated/*diagnostic imaging/mortality
MH  - *Contrast Media
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - *Gadolinium
MH  - Heart Ventricles/*diagnostic imaging
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Survival Analysis
PMC - PMC6261623
COIS- The authors have declared that no competing interests exist.
EDAT- 2018/11/30 06:00
MHDA- 2019/05/02 06:00
PMCR- 2018/11/28
CRDT- 2018/11/29 06:00
PHST- 2018/07/17 00:00 [received]
PHST- 2018/11/12 00:00 [accepted]
PHST- 2018/11/29 06:00 [entrez]
PHST- 2018/11/30 06:00 [pubmed]
PHST- 2019/05/02 06:00 [medline]
PHST- 2018/11/28 00:00 [pmc-release]
AID - PONE-D-18-21142 [pii]
AID - 10.1371/journal.pone.0208100 [doi]
PST - epublish
SO  - PLoS One. 2018 Nov 28;13(11):e0208100. doi: 10.1371/journal.pone.0208100. 
      eCollection 2018.