Journal article
Meta-Analysis of the Prognostic Role of Late Gadolinium Enhancement and Global Systolic Impairment in Left Ventricular Noncompaction.
- Grigoratos C Fondazione Gabriele Monasterio CNR/Regione Toscana, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
- Barison A Fondazione Gabriele Monasterio CNR/Regione Toscana, Pisa, Italy.
- Ivanov A Department of Cardiology, New York Methodist Hospital, Brooklyn, New York.
- Andreini D Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy.
- Amzulescu MS Division of Cardiology, Department of Cardiovascular Diseases Cliniques St. Luc and Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.
- Mazurkiewicz L Department of Cardiomyopathies, Institute of Cardiology, Warsaw, Poland; CMR Unit, Institute of Cardiology, Warsaw, Poland.
- De Luca A Fondazione Gabriele Monasterio CNR/Regione Toscana, Pisa, Italy.
- Grzybowski J Department of Cardiomyopathies, Institute of Cardiology, Warsaw, Poland.
- Masci PG Division of Cardiology and CMR-Center, University Hospital Lausanne, Lausanne, Switzerland.
- Marczak M CMR Unit, Institute of Cardiology, Warsaw, Poland.
- Heitner JF Department of Cardiology, New York Methodist Hospital, Brooklyn, New York.
- Schwitter J Division of Cardiology and CMR-Center, University Hospital Lausanne, Lausanne, Switzerland.
- Gerber BL Division of Cardiology, Department of Cardiovascular Diseases Cliniques St. Luc and Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.
- Emdin M Fondazione Gabriele Monasterio CNR/Regione Toscana, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
- Aquaro GD Fondazione Gabriele Monasterio CNR/Regione Toscana, Pisa, Italy. Electronic address: aquaro@ftgm.it.
- 2019-03-18
Published in:
- JACC. Cardiovascular imaging. - 2019
hypertrabeculation
late gadolinium enhancement
left ventricular noncompaction
prognosis
systolic impairment
Adult
Contrast Media
Female
Fibrosis
Humans
Isolated Noncompaction of the Ventricular Myocardium
Magnetic Resonance Imaging
Male
Middle Aged
Myocardium
Predictive Value of Tests
Prognosis
Risk Assessment
Risk Factors
Time Factors
Ventricular Dysfunction, Left
Ventricular Function, Left
Ventricular Remodeling
English
OBJECTIVES
The objective of this meta-analysis was to assess the predictive value of late gadolinium enhancement (LGE) and global systolic impairment for future major adverse cardiovascular events in left ventricular noncompaction (LVNC).
BACKGROUND
The prognosis of patients with LVNC, with and without left ventricular dysfunction and LGE, is still unclear.
METHODS
A systematic review of published research and a meta-analysis reporting a combined endpoint of hard (cardiac death, sudden cardiac death, appropriate defibrillator firing, resuscitated cardiac arrest, cardiac transplantation, assist device implantation) and minor (heart failure hospitalization and thromboembolic events) events was performed.
RESULTS
Four studies with 574 patients with LVNC and 677 with no LVNC and an average follow-up duration of 5.2 years were analyzed. In patients with LVNC, LGE was associated with the combined endpoint (pooled odds ratio: 4.9; 95% confidence interval: 1.63 to 14.6; p = 0.005) and cardiac death (pooled odds ratio: 9.8; 95% confidence interval: 2.44 to 39.5; p < 0.001). Preserved left ventricular systolic function was found in 183 patients with LVNC: 25 with positive LGE and 158 with negative LGE. In LVNC with preserved ejection fraction, positive LGE was associated with hard cardiac events (odds ratio: 6.1; 95% confidence interval: 2.1 to 17.5; p < 0.001). No hard cardiac events were recorded in patients with LVNC, preserved ejection fraction, and negative LGE.
CONCLUSIONS
Patients with LVNC but without LGE have a better prognosis than those with LGE. When LGE is negative and global systolic function is preserved, no hard cardiac events are to be expected. Currently available criteria allow diagnosis of LVNC, but to further define the presence and prognostic significance of the disease, LGE and/or global systolic impairment must be considered for better risk stratification.
The objective of this meta-analysis was to assess the predictive value of late gadolinium enhancement (LGE) and global systolic impairment for future major adverse cardiovascular events in left ventricular noncompaction (LVNC).
BACKGROUND
The prognosis of patients with LVNC, with and without left ventricular dysfunction and LGE, is still unclear.
METHODS
A systematic review of published research and a meta-analysis reporting a combined endpoint of hard (cardiac death, sudden cardiac death, appropriate defibrillator firing, resuscitated cardiac arrest, cardiac transplantation, assist device implantation) and minor (heart failure hospitalization and thromboembolic events) events was performed.
RESULTS
Four studies with 574 patients with LVNC and 677 with no LVNC and an average follow-up duration of 5.2 years were analyzed. In patients with LVNC, LGE was associated with the combined endpoint (pooled odds ratio: 4.9; 95% confidence interval: 1.63 to 14.6; p = 0.005) and cardiac death (pooled odds ratio: 9.8; 95% confidence interval: 2.44 to 39.5; p < 0.001). Preserved left ventricular systolic function was found in 183 patients with LVNC: 25 with positive LGE and 158 with negative LGE. In LVNC with preserved ejection fraction, positive LGE was associated with hard cardiac events (odds ratio: 6.1; 95% confidence interval: 2.1 to 17.5; p < 0.001). No hard cardiac events were recorded in patients with LVNC, preserved ejection fraction, and negative LGE.
CONCLUSIONS
Patients with LVNC but without LGE have a better prognosis than those with LGE. When LGE is negative and global systolic function is preserved, no hard cardiac events are to be expected. Currently available criteria allow diagnosis of LVNC, but to further define the presence and prognostic significance of the disease, LGE and/or global systolic impairment must be considered for better risk stratification.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1016/j.jcmg.2018.12.029
- PMID 30878415
- Persistent URL
- https://sonar.ch/global/documents/278259
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