Prognostic value of late gadolinium enhancement in dilated cardiomyopathy patients: a meta-analysis

Clin Radiol. 2015 Sep;70(9):999-1008. doi: 10.1016/j.crad.2015.05.007. Epub 2015 Jun 23.

Abstract

Aim: To evaluate the association between late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) and major adverse events in dilated cardiomyopathy (DCM) patients.

Materials and methods: Databases, including PubMed, Ovid, and EMBASE, were searched for studies evaluating LGE at CMR in DCM patient prognostication. Clinical outcomes were analysed using fixed-effects models or, in cases of significant heterogeneity, random-effects models.

Results: In the meta-analysis of 13 studies on 1675 DCM patients with a mean follow-up of 3 years, LGE is associated with all-cause mortality (pooled odds ratio, 3.43 [95% confidence interval, 2.26-5.22], p<0.00001), cardiac death/transplantation (3.65 [1.80-7.40], p=0.0003), hospitalisation for heart failure (2.87 [1.53-5.39], p=0.001), major arrhythmia events (sudden cardiac death, sustained ventricular tachycardia or fibrillation, appropriate implantable cardioverter-defibrillator (ICD) discharge/pacing, and syncope: 4.24 [2.95-6.08], p<0.00001), and sudden cardiac death (3.33 [1.80-6.17], p=0.0001).

Conclusion: LGE in DCM patients appears to be associated with mortality and major cardiac events, underscoring its potential as an independent index for risk stratification and treatment guidance.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiomyopathy, Dilated / diagnosis*
  • Contrast Media
  • Gadolinium
  • Humans
  • Magnetic Resonance Imaging, Cine*
  • Prognosis
  • Risk Assessment

Substances

  • Contrast Media
  • Gadolinium