TY - JOUR
T1 - Left ventricular geometric remodeling in relation to non-ischemic scar pattern on cardiac magnetic resonance imaging
AU - Kim, Jiwon
AU - Kochav, Jonathan D.
AU - Gurevich, Sergey
AU - Afroz, Anika
AU - Petashnick, Maya
AU - Volo, Samuel
AU - Diaz, Belen
AU - Okin, Peter M.
AU - Horn, Evelyn
AU - Devereux, Richard B.
AU - Weinsaft, Jonathan W.
N1 - Publisher Copyright:
© 2014, Springer Science+Business Media Dordrecht.
PY - 2014/12
Y1 - 2014/12
N2 - Left ventricular (LV) remodeling and myocardial fibrosis have been linked to adverse heart failure outcomes. Mid wall late gadolinium enhancement (MW-LGE) on cardiac magnetic resonance (CMR) imaging is well-associated with non-ischemic cardiomyopathy (NICM), but prevalence in ischemic cardiomyopathy (ICM) and association with remodeling are unknown. The population comprised patients with systolic dysfunction [LV ejection fraction (LVEF ≤ 40 %)]. CMR was used to identify MW-LGE, conventionally defined as fibrosis of the mid-myocardial or epicardial aspect of the LV septum. 285 patients were studied. MW-LGE was present in 12 %, and was tenfold more common with NICM (32 %) versus ICM (3 %, p < 0.001). However, owing to higher prevalence of ICM, 15 % of patients with MW-LGE had ICM. LV wall stress was higher (p = 0.02) among patients with, versus those without, MW-LGE despite similar systolic blood pressure (p = 0.24). In multivariate analysis, MW-LGE was associated with CMR-quantified LV end-diastolic volume (p = 0.03) independent of LVEF and mass. Incorporation of clinical and imaging variables demonstrated MW-LGE to be associated with higher LV end-diastolic volume (OR 1.13, CI 1.004–1.27 per 10 ml/m2, p = 0.04) after controlling for presence of NICM (OR 16.0, CI 5.8–44.1, p < 0.001). While more common in NICM, MW-LGE can occur in ICM and is a marker of LV chamber dilation irrespective of cardiomyopathic etiology.
AB - Left ventricular (LV) remodeling and myocardial fibrosis have been linked to adverse heart failure outcomes. Mid wall late gadolinium enhancement (MW-LGE) on cardiac magnetic resonance (CMR) imaging is well-associated with non-ischemic cardiomyopathy (NICM), but prevalence in ischemic cardiomyopathy (ICM) and association with remodeling are unknown. The population comprised patients with systolic dysfunction [LV ejection fraction (LVEF ≤ 40 %)]. CMR was used to identify MW-LGE, conventionally defined as fibrosis of the mid-myocardial or epicardial aspect of the LV septum. 285 patients were studied. MW-LGE was present in 12 %, and was tenfold more common with NICM (32 %) versus ICM (3 %, p < 0.001). However, owing to higher prevalence of ICM, 15 % of patients with MW-LGE had ICM. LV wall stress was higher (p = 0.02) among patients with, versus those without, MW-LGE despite similar systolic blood pressure (p = 0.24). In multivariate analysis, MW-LGE was associated with CMR-quantified LV end-diastolic volume (p = 0.03) independent of LVEF and mass. Incorporation of clinical and imaging variables demonstrated MW-LGE to be associated with higher LV end-diastolic volume (OR 1.13, CI 1.004–1.27 per 10 ml/m2, p = 0.04) after controlling for presence of NICM (OR 16.0, CI 5.8–44.1, p < 0.001). While more common in NICM, MW-LGE can occur in ICM and is a marker of LV chamber dilation irrespective of cardiomyopathic etiology.
KW - Cardiomyopathy
KW - Cardiovascular magnetic resonance
KW - Myocardial fibrosis
KW - Remodeling
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U2 - 10.1007/s10554-014-0487-8
DO - 10.1007/s10554-014-0487-8
M3 - Article
C2 - 25008088
AN - SCOPUS:84919706612
SN - 1569-5794
VL - 30
SP - 1559
EP - 1567
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
IS - 8
ER -