BACKGROUND: Cardiac magnetic resonance (CMR) is considered the reference standard for assessment of left ventricular ejection fraction (LVEF) and myocardial damage. However, few studies have evaluated the relationship between CMR findings and patient outcome, and of these, most are small and none multicenter. We performed an international, multicenter study to assess the prognostic importance of routine CMR in patients with known or suspected heart disease. METHODS AND RESULTS: From 10 centers in 6 countries, consecutive patients undergoing routine CMR assessment of LVEF and myocardial damage by cine and delayed-enhancement imaging (DE-CMR), respectively, were screened for enrollment. Clinical data, CMR protocol information, and findings were collected at all sites and submitted to the data coordinating center for verification of completeness and analysis. The primary end point was all-cause mortality. A total of 1560 patients (age, 59±14 years; 70% men) were enrolled. Mean LVEF was 45±18%, and 1049 (67%) patients had hyperenhanced tissue (HE) on DE-CMR indicative of damage. During a median follow-up time of 2.4 years (interquartile range, 1.2, 2.9 years), 176 (11.3%) patients died. Patients who died were more likely to be older (P<0.0001), have coronary disease (P=0.004), have lower LVEF (P<0.0001), and have more segments with HE (P<0.0001). In multivariable analysis, age, LVEF, and number of segments with HE were independent predictors of mortality. Among patients with near-normal LVEF (≥50%), those with above-median HE (>4 segments) had reduced survival compared to patients with below- or at-median HE (P=0.02). CONCLUSIONS: Both LVEF and amount of myocardial damage as assessed by routine CMR are independent predictors of all-cause mortality. Even in patients with near-normal LVEF, significant damage identifies a cohort with a high risk for early mortality.
BACKGROUND: Cardiac magnetic resonance (CMR) is considered the reference standard for assessment of left ventricular ejection fraction (LVEF) and myocardial damage. However, few studies have evaluated the relationship between CMR findings and patient outcome, and of these, most are small and none multicenter. We performed an international, multicenter study to assess the prognostic importance of routine CMR in patients with known or suspected heart disease. METHODS AND RESULTS: From 10 centers in 6 countries, consecutive patients undergoing routine CMR assessment of LVEF and myocardial damage by cine and delayed-enhancement imaging (DE-CMR), respectively, were screened for enrollment. Clinical data, CMR protocol information, and findings were collected at all sites and submitted to the data coordinating center for verification of completeness and analysis. The primary end point was all-cause mortality. A total of 1560 patients (age, 59±14 years; 70% men) were enrolled. Mean LVEF was 45±18%, and 1049 (67%) patients had hyperenhanced tissue (HE) on DE-CMR indicative of damage. During a median follow-up time of 2.4 years (interquartile range, 1.2, 2.9 years), 176 (11.3%) patients died. Patients who died were more likely to be older (P<0.0001), have coronary disease (P=0.004), have lower LVEF (P<0.0001), and have more segments with HE (P<0.0001). In multivariable analysis, age, LVEF, and number of segments with HE were independent predictors of mortality. Among patients with near-normal LVEF (≥50%), those with above-median HE (>4 segments) had reduced survival compared to patients with below- or at-median HE (P=0.02). CONCLUSIONS: Both LVEF and amount of myocardial damage as assessed by routine CMR are independent predictors of all-cause mortality. Even in patients with near-normal LVEF, significant damage identifies a cohort with a high risk for early mortality.
Authors: Tomas G Neilan; Ravi V Shah; Siddique A Abbasi; Hoshang Farhad; John D Groarke; John A Dodson; Otavio Coelho-Filho; Ciaran J McMullan; Bobak Heydari; Gregory F Michaud; Roy M John; Rob van der Geest; Michael L Steigner; Ron Blankstein; Michael Jerosch-Herold; Raymond Y Kwong Journal: J Am Coll Cardiol Date: 2013-08-28 Impact factor: 24.094
Authors: Simone Romano; Robert M Judd; Raymond J Kim; Han W Kim; John F Heitner; Dipan J Shah; Richard B Devereux; Pablo Salazar; Michael Trybula; Richard C Chia; Kaleigh Evans; Afshin Farzaneh-Far Journal: JACC Cardiovasc Imaging Date: 2018-11-05
Authors: Anthony A Holmes; Jorge Romero; Jeffrey M Levsky; Linda B Haramati; Newton Phuong; Leila Rezai-Gharai; Stuart Cohen; Lina Restrepo; Luis Ruiz-Guerrero; John D Fisher; Cynthia C Taub; Luigi Di Biase; Mario J Garcia Journal: J Interv Card Electrophysiol Date: 2017-11-15 Impact factor: 1.900
Authors: John F Heitner; Raymond J Kim; Han W Kim; Igor Klem; Dipan J Shah; Dany Debs; Afshin Farzaneh-Far; Venkateshwar Polsani; Jiwon Kim; Jonathan Weinsaft; Chetan Shenoy; Andrew Hughes; Preston Cargile; Jean Ho; Robert O Bonow; Elizabeth Jenista; Michele Parker; Robert M Judd Journal: JAMA Cardiol Date: 2019-03-01 Impact factor: 14.676
Authors: Simone Romano; Robert M Judd; Raymond J Kim; Han W Kim; Igor Klem; John F Heitner; Dipan J Shah; Jennifer Jue; Afshin Farzaneh-Far Journal: Radiology Date: 2017-09-14 Impact factor: 11.105
Authors: Simone Romano; Robert M Judd; Raymond J Kim; Han W Kim; Igor Klem; John F Heitner; Dipan J Shah; Jennifer Jue; Brent E White; Raksha Indorkar; Chetan Shenoy; Afshin Farzaneh-Far Journal: JACC Cardiovasc Imaging Date: 2018-01-17
Authors: A J van Ballegooijen; M Visser; M F Cotch; A E Arai; M Garcia; T B Harris; L J Launer; G Eiríksdóttir; V Gudnason; I A Brouwer Journal: J Clin Endocrinol Metab Date: 2013-04-12 Impact factor: 5.958
Authors: Maythem Saeed; Steve W Hetts; Loi Do; Sammir M Sullivan; Mark W Wilson Journal: Int J Cardiovasc Imaging Date: 2012-10-13 Impact factor: 2.357