PMID- 31838882
OWN - NLM
STAT- MEDLINE
DCOM- 20200611
LR  - 20220425
IS  - 1942-0080 (Electronic)
IS  - 1941-9651 (Print)
IS  - 1941-9651 (Linking)
VI  - 12
IP  - 12
DP  - 2019 Dec
TI  - Myocardial Extracellular Volume Fraction Adds Prognostic Information Beyond 
      Myocardial Replacement Fibrosis.
PG  - e009535
LID - 10.1161/CIRCIMAGING.119.009535 [doi]
AB  - BACKGROUND: Cardiac magnetic resonance techniques permit quantification of the 
      myocardial extracellular volume fraction (ECV), representing a surrogate marker 
      of reactive interstitial fibrosis, and late gadolinium enhancement (LGE), 
      representing replacement fibrosis or scar. ECV and LGE have been independently 
      linked with heart failure (HF) events. In deriving ECV, coronary artery disease 
      type LGE, but not non-coronary artery disease type LGE, has been consistently 
      excluded. We examined the associations between LGE, global ECV derived from 
      myocardial tissue segments free of any detectable scar, and subsequent HF events. 
      METHODS: Mid short-axis T1 maps were divided into 6 cardiac segments, each 
      classified as LGE absent or present. Global ECV was derived from only segments 
      without LGE. ECV was considered elevated if >30%, the upper 95% bounds of a 
      reference group without known cardiac disease (n=28). Patients were divided into 
      4 groups by presence of elevated ECV and of any LGE. Subsequent HF 
      hospitalization and any death were ascertained. Their relationship with ECV was 
      examined separately and as a composite with Cox proportional hazard models. 
      RESULTS: Of 1604 serial patients with T1 maps, 1255 were eligible after 
      exclusions and followed over a median 26.3 (interquartile range, 15.9-37.5) 
      months. Patients with elevated ECV had increased risk for death (hazard ratio 
      [HR] 2.45 [95% CI, 1.76-3.41]), HF hospitalization (HR, 2.45 [95% CI, 
      1.77-3.40]), and a combined end point of both outcomes (HR, 2.46 [95% CI, 
      1.94-3.14]). After adjustments for covariates including LGE, the relationship 
      persisted for death (HR, 1.82 [95% CI, 1.28-2.59]), hospitalization (HR, 1.60 
      [95% CI, 1.12-2.27]), and combined end points (HR, 1.73 [95% CI, 1.34-2.24]). 
      CONCLUSIONS: ECV measures of diffuse myocardial fibrosis were associated with HF 
      outcomes, despite exclusion of replacement fibrosis segments from their 
      derivation and even among patients without any scar. ECV may have a synergistic 
      role with LGE in HF risk assessment.
FAU - Yang, Eric Y
AU  - Yang EY
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
FAU - Ghosn, Mohamad G
AU  - Ghosn MG
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
FAU - Khan, Mohammad A
AU  - Khan MA
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
FAU - Gramze, Nickalaus L
AU  - Gramze NL
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
FAU - Brunner, Gerd
AU  - Brunner G
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
AD  - Department of Medicine, Baylor College of Medicine, Houston, TX (G.B., V.N., 
      C.M.B.).
FAU - Nabi, Faisal
AU  - Nabi F
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
FAU - Nambi, Vijay
AU  - Nambi V
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
AD  - Department of Medicine, Baylor College of Medicine, Houston, TX (G.B., V.N., 
      C.M.B.).
AD  - Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX (V.N.).
FAU - Nagueh, Sherif F
AU  - Nagueh SF
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
FAU - Nguyen, Duc T
AU  - Nguyen DT
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
FAU - Graviss, Edward A
AU  - Graviss EA
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
FAU - Schelbert, Erik B
AU  - Schelbert EB
AD  - Department of Medicine, University of Pittsburgh School of Medicine, PA (E.B.S.).
FAU - Ballantyne, Christie M
AU  - Ballantyne CM
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
AD  - Department of Medicine, Baylor College of Medicine, Houston, TX (G.B., V.N., 
      C.M.B.).
FAU - Zoghbi, William A
AU  - Zoghbi WA
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
FAU - Shah, Dipan J
AU  - Shah DJ
AD  - Houston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., 
      F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
LA  - eng
GR  - K25 HL121149/HL/NHLBI NIH HHS/United States
GR  - R01 HL137763/HL/NHLBI NIH HHS/United States
GR  - 1R01HL137763-01/HL/NHLBI NIH HHS/United States
GR  - 1646586/National Science Foundation/International
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20191216
PL  - United States
TA  - Circ Cardiovasc Imaging
JT  - Circulation. Cardiovascular imaging
JID - 101479935
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
CIN - Circ Cardiovasc Imaging. 2019 Dec;12(12):e010152. PMID: 31838884
MH  - Adult
MH  - Aged
MH  - Cardiomyopathies/*diagnosis
MH  - Contrast Media/pharmacology
MH  - Extracellular Space
MH  - Female
MH  - Fibrosis/diagnosis
MH  - Follow-Up Studies
MH  - Gadolinium DTPA/pharmacology
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Prognosis
MH  - Prospective Studies
MH  - Reproducibility of Results
PMC - PMC7529265
MID - NIHMS1548947
OTO - NOTNLM
OT  - epidemiology
OT  - extracellular matrix
OT  - extracellular space
OT  - fibrosis
OT  - gadolinium
OT  - magnetic resonance imaging
OT  - myocardium
EDAT- 2019/12/17 06:00
MHDA- 2020/06/12 06:00
PMCR- 2020/12/16
CRDT- 2019/12/17 06:00
PHST- 2019/12/17 06:00 [entrez]
PHST- 2019/12/17 06:00 [pubmed]
PHST- 2020/06/12 06:00 [medline]
PHST- 2020/12/16 00:00 [pmc-release]
AID - 10.1161/CIRCIMAGING.119.009535 [doi]
PST - ppublish
SO  - Circ Cardiovasc Imaging. 2019 Dec;12(12):e009535. doi: 
      10.1161/CIRCIMAGING.119.009535. Epub 2019 Dec 16.