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RESEARCH PRODUCT

Prevalence and prognostic impact of nonischemic late gadolinium enhancement in stress cardiac magnetic resonance

Ignazio GueliGiovanni Donato AquaroAntonella MeloniEike NagelValentina O. PuntmannChrysanthos GrigoratosChristophe T. ArendtAndrea BarisonGiancarlo TodiereMichele EmdinAlessia PepeDoris LeithnerCinzia NugaraGiuseppina Novo

subject

MaleAdenosineTime FactorsVasodilator AgentsContrast MediaPerfusion scanning030204 cardiovascular system & hematologyVentricular tachycardia0302 clinical medicineRisk FactorsInterquartile rangePrevalence030212 general & internal medicineMyocardial infarctionStrokenonischemic fibrosislate gadolinium enhancement; nonischemic cardiac findings; nonischemic fibrosis; prognosis; stress perfusion cardiac magnetic resonanceDipyridamoleGeneral MedicineMiddle AgedMagnetic Resonance ImagingDipyridamolelate gadolinium enhancementstress perfusion cardiac magnetic resonanceembryonic structurescardiovascular systemCardiologyFemaleCardiology and Cardiovascular MedicinePerfusionmedicine.drugnonischemic cardiac findingsmedicine.medical_specialtyHeart DiseasesPerfusion ImagingRisk Assessment03 medical and health sciencesPredictive Value of TestsInternal medicinemedicineHumanscardiovascular diseasesSurvival analysisAgedRetrospective Studiesbusiness.industryMyocardiummedicine.diseaseFibrosisLate gadolinium enhancement Nonischemic cardiac findings Nonischemic fibrosis Prognosis Stress perfusion cardiac magnetic resonanceprognosisbusiness

description

Aim To assess the prevalence and prognostic significance of NI-LGE in patients undergoing stress-CMR. Methods Stress-CMR with either dipyridamole or adenosine was performed in 283 patients (228 men, 81%) including perfusion imaging, wall motion evaluation and LGE. Follow-up was completed in all enrolled patients (median time: 1850 days; interquartile range: 1225-2705 days). Composite endpoint included cardiac death, ventricular tachycardia, myocardial infarction, stroke, hospitalization for cardiac cause and coronary revascularization performed beyond 90 days from stress-CMR scans. Results One hundred and twelve patients (40%) had negative LGE (no-LGE), 140 patients (49%) I-LGE and 31 patients (11%) NI-LGE. Twenty-five events occurred in the no-LGE group, 68 in I-LGE and 11 in the NI-LGE group. On survival curves, patients with NI-LGE had worse prognosis than patients with no-LGE regardless of the presence of inducible perfusion defects. No significant prognostic differences were found between I-LGE and NI-LGE. Conclusion NI-LGE can be detected in 11% of patients during stress-CMR providing a diagnosis of nonischemic cardiac disease. Patients with NI-LGE have worse prognosis than those with no-LGE.

yearjournalcountryeditionlanguage
2020-01-01Journal of Cardiovascular Medicine
https://doi.org/10.2459/jcm.0000000000001016