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.
제1저자 이승아 · 교신저자 윤연이
소속 (6)
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine, National Medical Centers, Seoul, Korea.
- 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.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
- Department of Thoracic Surgery, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
- 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