Prognostic Significance of Delayed-Enhancement Magnetic Resonance Imaging: Survival of 857 Patients With and Without Left Ventricular Dysfunction

Left ventricular ejection fraction is a powerful independent predictor of survival in cardiac patients, especially those with coronary artery disease. Delayed-enhancement magnetic resonance imaging (DE-MRI) can accurately identify irreversible myocardial injury with high spatial and contrast resolut...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2009-11, Vol.120 (21), p.2069-2076
Main Authors: CHEONG, Benjamin Y. C, MUTHUPILLAI, Raja, WILSON, James M, SUNG, Angela, HUBER, Steffen, AMIN, Samir, ELAYDA, Macarthur A, LEE, Vei-Vei, FLAMM, Scott D
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiovascular system
Coronary Artery Disease - mortality
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Female
Heart Transplantation
Humans
Image Enhancement
Magnetic Resonance Imaging - methods
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Prognosis
Stroke Volume
Vasodilator agents. Cerebral vasodilators
Ventricular Dysfunction, Left - diagnosis
Ventricular Dysfunction, Left - mortality
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Summary:Left ventricular ejection fraction is a powerful independent predictor of survival in cardiac patients, especially those with coronary artery disease. Delayed-enhancement magnetic resonance imaging (DE-MRI) can accurately identify irreversible myocardial injury with high spatial and contrast resolution. To date, relatively limited data are available on the prognostic value of DE-MRI, so we sought to determine whether DE-MRI findings independently predict survival. The medical records of 857 consecutive patients who had complete cine and DE-MRI evaluation at a tertiary care center were reviewed regardless of whether the patients had coronary artery disease. The presence and extent of myocardial scar were evaluated qualitatively by a single experienced observer. The primary, composite end point was all-cause mortality or cardiac transplantation. Survival data were obtained from the Social Security Death Index. The median follow-up was 4.4 years; 252 patients (29%) reached one of the end points. Independent predictors of mortality or transplantation included congestive heart failure, ejection fraction, and age (P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.109.852517