Journal article
Prognostic Implications of Left Ventricular Scar Determined by Late Gadolinium Enhanced Cardiac Magnetic Resonance in Patients With Atrial Fibrillation
The American journal of cardiology, Vol.118(7), pp.991-997
10/01/2016
DOI: 10.1016/j.amjcard.2016.06.054
PMID: 27553101
Abstract
Left ventricular (LV) scar identified by late gadolinium enhanced (LGE) cardiac magnetic resonance (CMR) is associated with adverse outcomes in coronary artery disease and cardiomyopathies. We sought to determine the prognostic significance of LV-LGE in atrial fibrillation (AF). We studied 778 consecutive patients referred for radiofrequency ablation of AF who underwent CMR. Patients with coronary artery disease, previous myocardial infarction, or hypertrophic or dilated cardiomyopathy were excluded. The end points of interest were major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of cardiovascular death, myocardial infarction, and ischemic stroke/transient ischemic attack. Of the 754 patients who met the inclusion criteria, 60% were men with an average age of 64 years. Most (87%) had a normal LV ejection fraction of ≥55%. LV-LGE was found in 46 patients (6%). There were 32 MACCE over the mean follow-up period of 55 months. The MACCE rate was higher for patients with LV-LGE (13.0% vs 3.7%; p = 0.002). In multivariate analysis, CHA2DS2-VASc score (hazard ratio [HR] 1.36, 95% CI 1.05 to 1.76), the presence of LV-LGE (HR 3.21, 95% CI 1.31 to 7.88), and the LV-LGE extent (HR 1.43, 95% CI 1.15 to 1.78) were independent predictors of MACCE. In addition, the presence of LV-LGE was an independent predictor for ischemic stroke/transient ischemic attack (HR 3.61, 95% CI 1.18 to 11.01) after adjusting for CHA2DS2-VASc score. In conclusion, the presence and extent of LV scar identified by LGE-CMR were independent predictors of MACCE in patients with AF.
Details
- Title: Subtitle
- Prognostic Implications of Left Ventricular Scar Determined by Late Gadolinium Enhanced Cardiac Magnetic Resonance in Patients With Atrial Fibrillation
- Creators
- Promporn Suksaranjit - University of UtahChristopher J. McGann - University of UtahNazem Akoum - University of WashingtonJoseph Biskupiak - University of UtahGregory J. Stoddard - University of UtahEugene G. Kholmovski - University of UtahLeenhapong Navaravong - University of UtahAllen Rassa - University of UtahErik Bieging - University of UtahLowell Chang - University of UtahImran Haider - University of UtahNassir F. Marrouche - University of UtahBrent D. Wilson - University of Utah
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.118(7), pp.991-997
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.amjcard.2016.06.054
- PMID
- 27553101
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Language
- English
- Date published
- 10/01/2016
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984360060302771
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