Incremental value of Late Gadolinium Enhancement by Cardiac MRI in risk stratification of heart failure patients with moderate and severe LV dysfunction
Objective: This is a prospective study of patients with LVEF ≤40%, with the objective of correlating CV events to LGE detected and quantified by CMRI. Methods: Heart Failure (HF) patients with LVEF <40% who underwent CMRI were included. LGE volume of ≥6% of the myocardial volume was considered si...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-01-01
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| Series: | Indian Heart Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483220304168 |
| _version_ | 1830191620644929536 |
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| author | Laxman Kolluru Jwala Srikala H. Nagaraj Rao Sania Maheen B. Hygriv Rao |
| author_facet | Laxman Kolluru Jwala Srikala H. Nagaraj Rao Sania Maheen B. Hygriv Rao |
| author_sort | Laxman Kolluru |
| collection | DOAJ |
| description | Objective: This is a prospective study of patients with LVEF ≤40%, with the objective of correlating CV events to LGE detected and quantified by CMRI. Methods: Heart Failure (HF) patients with LVEF <40% who underwent CMRI were included. LGE volume of ≥6% of the myocardial volume was considered significant. Data of appropriate ICD shocks, CV hospitalizations and mortality were recorded. Results: There were 133 HF (72 ICM & 62 NIDCM) patients with a mean age of 54 ± 12 years, mean LVEF of 34 ± 6% and a follow up of 24 ± 3 months. Totally 46 CV events were recorded in 30 patients, 44 in LGE +ve & 2 in LGE -ve groups (HR 17.8, 95% CI-8.03-39.3, P = 0.000095). All the 7 deaths were in LGE +ve group. CV events were 22 (30.5%) in ICM group and 8 (13.1%) in NIDCM group (p = 0.03). All the 22 ICM patients and 6 of the 8 NIDCM with CV events were LGE +ve. The distribution of CV events amongst LGE +ve and LGE -ve were 35 vs 0 (ICM) and 9 vs 2 (NIDCM); p < 0.005.CV events in LVEF ≤ 30% group, were seen in 19 (47.5%) vs 1 (5.8%) in LGE +ve vs LGE -ve and no of events were 29 vs 1 (p = 0.003). In those with LVEF >30% the corresponding figures were 9 (22.5%) vs 1 (2.8%) and 15 vs 1 respectively (p = 0.02). Conclusion: Demonstration of significant LGE by CMRI indicates high risk occurrence of CV events (CV hospitalization, appropriate shocks and total mortality) in NIDCM & ICM patients with LVEF < 40%. |
| first_indexed | 2024-12-17T23:42:16Z |
| format | Article |
| id | doaj.art-3344e001d1f74369ac89dca1a4761acb |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-12-17T23:42:16Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-3344e001d1f74369ac89dca1a4761acb2022-12-21T21:28:25ZengElsevierIndian Heart Journal0019-48322021-01-017314955Incremental value of Late Gadolinium Enhancement by Cardiac MRI in risk stratification of heart failure patients with moderate and severe LV dysfunctionLaxman Kolluru0Jwala Srikala1H. Nagaraj Rao2Sania Maheen3B. Hygriv Rao4Department of Cardiology, KIMS Hospitals, Hyderabad, IndiaDepartment of Radiology, KIMS Hospitals, Hyderabad, IndiaDepartment of Cardiology, KIMS Hospitals, Nellore, IndiaDepartment of Radiology, KIMS Hospitals, Hyderabad, IndiaDepartment of Cardiology, KIMS Hospitals, Hyderabad, India; Arrhythmia Research & Training Society(ARTS), Hyderabad, India; Corresponding author. Division of Pacing & Electrophysiology, KIMS Group of Hospitals, Minister Road, Hyderabad 500003, India.Objective: This is a prospective study of patients with LVEF ≤40%, with the objective of correlating CV events to LGE detected and quantified by CMRI. Methods: Heart Failure (HF) patients with LVEF <40% who underwent CMRI were included. LGE volume of ≥6% of the myocardial volume was considered significant. Data of appropriate ICD shocks, CV hospitalizations and mortality were recorded. Results: There were 133 HF (72 ICM & 62 NIDCM) patients with a mean age of 54 ± 12 years, mean LVEF of 34 ± 6% and a follow up of 24 ± 3 months. Totally 46 CV events were recorded in 30 patients, 44 in LGE +ve & 2 in LGE -ve groups (HR 17.8, 95% CI-8.03-39.3, P = 0.000095). All the 7 deaths were in LGE +ve group. CV events were 22 (30.5%) in ICM group and 8 (13.1%) in NIDCM group (p = 0.03). All the 22 ICM patients and 6 of the 8 NIDCM with CV events were LGE +ve. The distribution of CV events amongst LGE +ve and LGE -ve were 35 vs 0 (ICM) and 9 vs 2 (NIDCM); p < 0.005.CV events in LVEF ≤ 30% group, were seen in 19 (47.5%) vs 1 (5.8%) in LGE +ve vs LGE -ve and no of events were 29 vs 1 (p = 0.003). In those with LVEF >30% the corresponding figures were 9 (22.5%) vs 1 (2.8%) and 15 vs 1 respectively (p = 0.02). Conclusion: Demonstration of significant LGE by CMRI indicates high risk occurrence of CV events (CV hospitalization, appropriate shocks and total mortality) in NIDCM & ICM patients with LVEF < 40%.http://www.sciencedirect.com/science/article/pii/S0019483220304168Heart failureCMRILate Gadolinium EnhancementMyocardial scarMortalityCardiomyopathy |
| spellingShingle | Laxman Kolluru Jwala Srikala H. Nagaraj Rao Sania Maheen B. Hygriv Rao Incremental value of Late Gadolinium Enhancement by Cardiac MRI in risk stratification of heart failure patients with moderate and severe LV dysfunction Indian Heart Journal Heart failure CMRI Late Gadolinium Enhancement Myocardial scar Mortality Cardiomyopathy |
| title | Incremental value of Late Gadolinium Enhancement by Cardiac MRI in risk stratification of heart failure patients with moderate and severe LV dysfunction |
| title_full | Incremental value of Late Gadolinium Enhancement by Cardiac MRI in risk stratification of heart failure patients with moderate and severe LV dysfunction |
| title_fullStr | Incremental value of Late Gadolinium Enhancement by Cardiac MRI in risk stratification of heart failure patients with moderate and severe LV dysfunction |
| title_full_unstemmed | Incremental value of Late Gadolinium Enhancement by Cardiac MRI in risk stratification of heart failure patients with moderate and severe LV dysfunction |
| title_short | Incremental value of Late Gadolinium Enhancement by Cardiac MRI in risk stratification of heart failure patients with moderate and severe LV dysfunction |
| title_sort | incremental value of late gadolinium enhancement by cardiac mri in risk stratification of heart failure patients with moderate and severe lv dysfunction |
| topic | Heart failure CMRI Late Gadolinium Enhancement Myocardial scar Mortality Cardiomyopathy |
| url | http://www.sciencedirect.com/science/article/pii/S0019483220304168 |
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