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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DOI: 10.1002/ejhf.2514
eISSN: 1879-0844
WOS ID: 000798578300001
Scopus EID: 2-s2.0-85130970777
PMID: 35485241
Embase PUI: L2017089073
Embase PUI: L2017089073
Embase PUI: L2017089073
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Mirelis, 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

Publication date
2022-07Document type
research articleCitation
Mirelis 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.Abstract
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.
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https://doi.org/10.1002/ejhf.2514MeSH
GenotypeCicatrix
Cardiomyopathy, Dilated
Humans
Arrhythmias, Cardiac
Contrast Media
Heart Failure
Prognosis
Gadolinium
Male
Predictive Value of Tests
Female
Magnetic Resonance Imaging, Cine
Retrospective Studies
DeCS
Imagen por Resonancia CinemagnéticaFemenino
Gadolinio
Masculino
Insuficiencia Cardíaca
Medios de Contraste
Cardiomiopatía Dilatada
Arritmias Cardíacas
Humanos
Valor Predictivo de las Pruebas
Pronóstico
Cicatriz
Genotipo
Estudios Retrospectivos
This item appears in following Docusalut collections
Instituto de Investigación Sanitaria Islas Baleares - IDISBA > Comunicación científicaHospital Universitario Son Llàtzer - HUSLL > Comunicación científica
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