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Am J Cardiol. 2016;118(11):1647-1654.

Long-Term Prognostic Value of Late Gadolinium-Enhanced Magnetic Resonance Imaging in Patients With and Without Left Ventricular Dysfunction Undergoing Coronary Artery Bypass Grafting.

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제1저자 이승아 · 교신저자 윤연이

소속 (6)
  1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine, National Medical Centers, Seoul, Korea.
  2. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea. Electronic address: yeonyeeyoon@gmail.com.
  3. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  4. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
  5. Department of Thoracic Surgery, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
  6. Department of Radiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract

The value of late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) for the prediction of functional recovery after surgical revascularization has been previously established. However, the impact of LGE-MRI on the long-term prognosis after coronary artery bypass grafting (CABG) remains incompletely understood. Therefore, we aimed to evaluate the long-term prognostic value of LGE-MRI, based on the presence or absence of left ventricular (LV) dysfunction, in patients with coronary artery disease undergoing CABG. One hundred forty-six consecutive patients underwent cine- and LGE-MRI before CABG. Adverse cardiac events included cardiac death, nonfatal myocardial infarction, heart failure, and unstable angina. A 3-year landmark analysis of the primary end point was also performed for patients surviving beyond 3 years after CABG. During a median follow-up of 9.4 years, 44 patients (30%) experienced adverse cardiac events. Although a LV ejection fraction <50% was associated only with adverse cardiac events at 3 years after CABG, LGE was associated with a worse outcome both at and beyond 3 years after CABG. In the overall study population, LGE presence (adjusted hazard ratio [HR] 2.58; p = 0.027), score (adjusted HR 1.06; p <0.001), and extent (adjusted HR 1.08; p <0.001) were independent predictors of adverse cardiac events. Moreover, in both the LV ejection fraction <50% and ≥50% groups, the LGE extent was an independent predictor of adverse cardiac events. In conclusion, our qualitative and quantitative analyses of LGE-MRI provide long-term prognostic information after surgical revascularization. The LGE extent was a strong predictor of adverse cardiac events, independent of the LV function.

Copyright © 2016 Elsevier Inc. All rights reserved.

그 밖의 정보
출판 형태
Journal Article
저널
The American journal of cardiology · eISSN 1879-1913
전자 출판
2016-08-30
MeSH
Aged · Contrast Media / administration & dosage · Coronary Artery Bypass* · Coronary Artery Disease / complications / diagnosis / surgery · Delayed Diagnosis · Female · Follow-Up Studies · Gadolinium DTPA / administration & dosage · Heart Ventricles / diagnostic imaging / physiopathology · Humans · Injections, Intravenous · Magnetic Resonance Imaging, Cine / methods · Male · Middle Aged · Myocardium / pathology · Preoperative Period · Prognosis · Reproducibility of Results · Retrospective Studies · Time Factors · Ventricular Dysfunction, Left / complications / diagnosis
Substances
Contrast Media · gadodiamide · Gadolinium DTPA