Pattern of late gadolinium enhancement predicts arrhythmic events in patients with non-ischemic cardiomyopathy

Dong Geum Shin, Hye Jeong Lee, Junbeom Park, Jae Sun Uhm, Hui Nam Pak, Moon Hyoung Lee, Young Jin Kim, Boyoung Joung

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Left ventricular late gadolinium enhancement (LV-LGE) by cardiac magnetic resonance (CMR) imaging has been associated with adverse clinical outcomes in patients with non-ischemic cardiomyopathy (NICM). However, an association between the characteristics of the LGE and arrhythmic risk has not been demonstrated consistently. This study evaluated the impact of the LV-LGE characteristics on the arrhythmia risk in patients with NICM. Methods This study enrolled 365 consecutive patients (54 ± 15 years) with NICM who underwent CMR imaging. All patients were monitored for the following outcomes: major arrhythmic events (MA), including sustained ventricular tachycardia, an appropriate implantable cardioverter–defibrillator intervention, ventricular fibrillation and sudden cardiac death. Results During 44.3 ± 36.4 months of follow-up, 44 (12.1%) patients experienced MA. LV-LGE was observed in 40 (90.9%) and 221 (68.8%) patients with and without MA, respectively. LV-LGE was more frequently observed in the MA group (p = 0.002). The age- and sex-adjusted hazard ratio (HR) of MA was increased in patients with LGE extent ≥ 8% (HR 8.45, 95% confidence interval (CI) 2.91–24.6), and those with subendocardial (HR 6.98, 95% CI 1.74–28.0) and subepicardial LGE patterns (HR 7.2, 95% CI 1.61–35.6). In multivariable models adjusted for other clinical variables, only the subepicardial LGE pattern had 7.2 (95% CI, 1.61–32.6, p = 0.01) time increase in the MA risk. Conclusions LV-LGE in patients with NICM is not uncommon. The subepicardial pattern of the LV-LGE was an independent predictor of MA, suggesting that specific patterns of the LV-LGE are closely related to the severity of arrhythmic events.

Original languageEnglish
Pages (from-to)9-15
Number of pages7
JournalInternational Journal of Cardiology
Volume222
DOIs
Publication statusPublished - 2016 Nov 1

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Gadolinium
Cardiomyopathies
Confidence Intervals
Magnetic Resonance Imaging
Sudden Cardiac Death
Ventricular Fibrillation
Ventricular Tachycardia
Cardiac Arrhythmias

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{5b9bd10ad4f34002ad6d4d36bc4b6383,
title = "Pattern of late gadolinium enhancement predicts arrhythmic events in patients with non-ischemic cardiomyopathy",
abstract = "Background Left ventricular late gadolinium enhancement (LV-LGE) by cardiac magnetic resonance (CMR) imaging has been associated with adverse clinical outcomes in patients with non-ischemic cardiomyopathy (NICM). However, an association between the characteristics of the LGE and arrhythmic risk has not been demonstrated consistently. This study evaluated the impact of the LV-LGE characteristics on the arrhythmia risk in patients with NICM. Methods This study enrolled 365 consecutive patients (54 ± 15 years) with NICM who underwent CMR imaging. All patients were monitored for the following outcomes: major arrhythmic events (MA), including sustained ventricular tachycardia, an appropriate implantable cardioverter–defibrillator intervention, ventricular fibrillation and sudden cardiac death. Results During 44.3 ± 36.4 months of follow-up, 44 (12.1{\%}) patients experienced MA. LV-LGE was observed in 40 (90.9{\%}) and 221 (68.8{\%}) patients with and without MA, respectively. LV-LGE was more frequently observed in the MA group (p = 0.002). The age- and sex-adjusted hazard ratio (HR) of MA was increased in patients with LGE extent ≥ 8{\%} (HR 8.45, 95{\%} confidence interval (CI) 2.91–24.6), and those with subendocardial (HR 6.98, 95{\%} CI 1.74–28.0) and subepicardial LGE patterns (HR 7.2, 95{\%} CI 1.61–35.6). In multivariable models adjusted for other clinical variables, only the subepicardial LGE pattern had 7.2 (95{\%} CI, 1.61–32.6, p = 0.01) time increase in the MA risk. Conclusions LV-LGE in patients with NICM is not uncommon. The subepicardial pattern of the LV-LGE was an independent predictor of MA, suggesting that specific patterns of the LV-LGE are closely related to the severity of arrhythmic events.",
author = "Shin, {Dong Geum} and Lee, {Hye Jeong} and Junbeom Park and Uhm, {Jae Sun} and Pak, {Hui Nam} and Lee, {Moon Hyoung} and Kim, {Young Jin} and Boyoung Joung",
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Pattern of late gadolinium enhancement predicts arrhythmic events in patients with non-ischemic cardiomyopathy. / Shin, Dong Geum; Lee, Hye Jeong; Park, Junbeom; Uhm, Jae Sun; Pak, Hui Nam; Lee, Moon Hyoung; Kim, Young Jin; Joung, Boyoung.

In: International Journal of Cardiology, Vol. 222, 01.11.2016, p. 9-15.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pattern of late gadolinium enhancement predicts arrhythmic events in patients with non-ischemic cardiomyopathy

AU - Shin, Dong Geum

AU - Lee, Hye Jeong

AU - Park, Junbeom

AU - Uhm, Jae Sun

AU - Pak, Hui Nam

AU - Lee, Moon Hyoung

AU - Kim, Young Jin

AU - Joung, Boyoung

PY - 2016/11/1

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N2 - Background Left ventricular late gadolinium enhancement (LV-LGE) by cardiac magnetic resonance (CMR) imaging has been associated with adverse clinical outcomes in patients with non-ischemic cardiomyopathy (NICM). However, an association between the characteristics of the LGE and arrhythmic risk has not been demonstrated consistently. This study evaluated the impact of the LV-LGE characteristics on the arrhythmia risk in patients with NICM. Methods This study enrolled 365 consecutive patients (54 ± 15 years) with NICM who underwent CMR imaging. All patients were monitored for the following outcomes: major arrhythmic events (MA), including sustained ventricular tachycardia, an appropriate implantable cardioverter–defibrillator intervention, ventricular fibrillation and sudden cardiac death. Results During 44.3 ± 36.4 months of follow-up, 44 (12.1%) patients experienced MA. LV-LGE was observed in 40 (90.9%) and 221 (68.8%) patients with and without MA, respectively. LV-LGE was more frequently observed in the MA group (p = 0.002). The age- and sex-adjusted hazard ratio (HR) of MA was increased in patients with LGE extent ≥ 8% (HR 8.45, 95% confidence interval (CI) 2.91–24.6), and those with subendocardial (HR 6.98, 95% CI 1.74–28.0) and subepicardial LGE patterns (HR 7.2, 95% CI 1.61–35.6). In multivariable models adjusted for other clinical variables, only the subepicardial LGE pattern had 7.2 (95% CI, 1.61–32.6, p = 0.01) time increase in the MA risk. Conclusions LV-LGE in patients with NICM is not uncommon. The subepicardial pattern of the LV-LGE was an independent predictor of MA, suggesting that specific patterns of the LV-LGE are closely related to the severity of arrhythmic events.

AB - Background Left ventricular late gadolinium enhancement (LV-LGE) by cardiac magnetic resonance (CMR) imaging has been associated with adverse clinical outcomes in patients with non-ischemic cardiomyopathy (NICM). However, an association between the characteristics of the LGE and arrhythmic risk has not been demonstrated consistently. This study evaluated the impact of the LV-LGE characteristics on the arrhythmia risk in patients with NICM. Methods This study enrolled 365 consecutive patients (54 ± 15 years) with NICM who underwent CMR imaging. All patients were monitored for the following outcomes: major arrhythmic events (MA), including sustained ventricular tachycardia, an appropriate implantable cardioverter–defibrillator intervention, ventricular fibrillation and sudden cardiac death. Results During 44.3 ± 36.4 months of follow-up, 44 (12.1%) patients experienced MA. LV-LGE was observed in 40 (90.9%) and 221 (68.8%) patients with and without MA, respectively. LV-LGE was more frequently observed in the MA group (p = 0.002). The age- and sex-adjusted hazard ratio (HR) of MA was increased in patients with LGE extent ≥ 8% (HR 8.45, 95% confidence interval (CI) 2.91–24.6), and those with subendocardial (HR 6.98, 95% CI 1.74–28.0) and subepicardial LGE patterns (HR 7.2, 95% CI 1.61–35.6). In multivariable models adjusted for other clinical variables, only the subepicardial LGE pattern had 7.2 (95% CI, 1.61–32.6, p = 0.01) time increase in the MA risk. Conclusions LV-LGE in patients with NICM is not uncommon. The subepicardial pattern of the LV-LGE was an independent predictor of MA, suggesting that specific patterns of the LV-LGE are closely related to the severity of arrhythmic events.

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