Left ventricular geometric remodeling in relation to non-ischemic scar pattern on cardiac magnetic resonance imaging Academic Article uri icon

Overview

MeSH Major

  • Cardiomyopathies
  • Cicatrix
  • Magnetic Resonance Imaging, Cine
  • Myocardial Ischemia
  • Myocardium
  • Ventricular Dysfunction, Left
  • Ventricular Function, Left
  • Ventricular Remodeling

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 ≤ 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.

publication date

  • January 2014

Research

keywords

  • Academic Article

Identity

Language

  • eng

PubMed Central ID

  • PMC4233172

Digital Object Identifier (DOI)

  • 10.1007/s10554-014-0487-8

PubMed ID

  • 25008088

Additional Document Info

start page

  • 1559

end page

  • 67

volume

  • 30

number

  • 8