Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/18072
Combination of late gadolinium enhancement and genotype improves prediction of prognosis in non-ischaemic dilated cardiomyopathy.
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AuthorMirelis, Jesús G; Escobar-Lopez, Luis; Ochoa, Juan Pablo; Espinosa, Maria Angeles; Villacorta, Eduardo; Navarro, Marina; Casas, Guillem; Mora-Ayestarán, Nerea; Barriales-Villa, Roberto; Mogollón-Jiménez, María Victoria; García-Pinilla, José M; García-Granja, Pablo Elpidio; Climent, Vicente; Palomino-Doza, Julian; García-Álvarez, Ana; Álvarez-Barredo, María; Cabrera-Borrego, Eva; Ripoll-Vera, Tomás ; Peña-Peña, María Luisa; Rodríguez-González, Elena; Gallego-Delgado, María; Gonzalez-Carrillo, Josefa; Fernández-Ávila, Ana; Rodríguez-Palomares, José F; Brugada, Ramón; Bayes-Genis, Antoni; Dominguez, Fernando; García-Pavía, Pablo
Document typeresearch article
CitationMirelis JG, Escobar‐Lopez L, Ochoa JP, Espinosa MÁ, Villacorta E, Navarro M, et al. Combination of late gadolinium enhancement and genotype improves prediction of prognosis in non‐ischaemic dilated cardiomyopathy. Eur J Heart Fail. 2022 May 22.
Genotype and left ventricular scar on cardiac magnetic resonance (CMR) are increasingly recognized as risk markers for adverse outcomes in non-ischaemic dilated cardiomyopathy (DCM). We investigated the combined influence of genotype and late gadolinium enhancement (LGE) in assessing prognosis in a large cohort of patients with DCM. Outcomes of 600 patients with DCM (53.3 ± 14.1 years, 66% male) who underwent clinical CMR and genetic testing were retrospectively analysed. The primary endpoints were end-stage heart failure (ESHF) and malignant ventricular arrhythmias (MVA). During a median follow-up of 2.7 years (interquartile range 1.3-4.9), 24 (4.00%) and 48 (8.00%) patients had ESHF and MVA, respectively. In total, 242 (40.3%) patients had pathogenic/likely pathogenic variants (positive genotype) and 151 (25.2%) had LGE. In survival analysis, positive LGE was associated with MVA and ESHF (both, p < 0.001) while positive genotype was associated with ESHF (p = 0.034) but not with MVA (p = 0.102). Classification of patients according to genotype (G+/G-) and LGE presence (L+/L-) revealed progressively increasing events across L-/G-, L-/G+, L+/G- and L+/G+ groups and resulted in optimized MVA and ESHF prediction (p < 0.001 and p = 0.001, respectively). Hazard ratios for MVA and ESHF in patients with either L+ or G+ compared with those with L-/G- were 4.71 (95% confidence interval: 2.11-10.50, p < 0.001) and 7.92 (95% confidence interval: 1.86-33.78, p < 0.001), respectively. Classification of patients with DCM according to genotype and LGE improves MVA and ESHF prediction. Scar assessment with CMR and genotyping should be considered to select patients for primary prevention implantable cardioverter-defibrillator placement.
Predictive Value of Tests
Magnetic Resonance Imaging, Cine
DeCSImagen por Resonancia Cinemagnética
Medios de Contraste
Valor Predictivo de las Pruebas
This item appears in following Docusalut collectionsInstituto de Investigación Sanitaria Islas Baleares - IDISBA > Comunicación científica
Hospital Universitario Son Llàtzer - HUSLL > Comunicación científica
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