Left ventricular geometric remodeling in relation to non-ischemic scar pattern on cardiac magnetic resonance imaging Journal Article
| Authors: | Kim, J.; Kochav, J. D.; Gurevich, S.; Afroz, A.; Petashnick, M.; Volo, S.; Diaz, B.; Okin, P. M.; Horn, E.; Devereux, R. B.; Weinsaft, J. W. |
| Article Title: | Left ventricular geometric remodeling in relation to non-ischemic scar pattern on cardiac magnetic resonance imaging |
| Abstract: | 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 a parts per thousand currency sign 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/m(2), 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. |
| Keywords: | survival; mortality; cardiomyopathy; dysfunction; acute myocardial-infarction; congestive-heart-failure; remodeling; cardiovascular magnetic resonance; myocardial fibrosis; idiopathic dilated cardiomyopathy; matrix-metalloproteinase activity; late gadolinium enhancement; systolic volume index; chamber quantification |
| Journal Title: | International Journal of Cardiovascular Imaging |
| Volume: | 30 |
| Issue: | 8 |
| ISSN: | 1569-5794 |
| Publisher: | Springer |
| Date Published: | 2014-12-01 |
| Start Page: | 1559 |
| End Page: | 1567 |
| Language: | English |
| ACCESSION: | WOS:000345093100019 |
| DOI: | 10.1007/s10554-014-0487-8 |
| PROVIDER: | wos |
| PMCID: | PMC4233172 |
| PUBMED: | 25008088 |
| Notes: | Article -- Source: Wos |
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