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- Title
Prognostic Value of Late Gadolinium Enhancement in Predicting Life-Threatening Arrhythmias in Heart Failure Patients With Implantable Cardioverter-Defibrillators: A Systematic Review and Meta-Analysis.
- Authors
Yue, Ting; Chen, Bing‐Hua; Wu, Lian‐Ming; Xu, Jian‐Rong; Pu, Jun; Chen, Bing-Hua; Wu, Lian-Ming; Xu, Jian-Rong
- Abstract
<bold>Background: </bold>The presence of late gadolinium enhanced (LGE), which may enable better evaluation of myocardial impairment, would help predict the occurrence of life-threatening arrhythmias and major adverse cardiovascular events (MACE) in patients suffering from ischemic cardiomyopathy (ICM) and nonischemic cardiomyopathy (NICM) patients and who underwent a process of implantable cardioverter-defibrillator (ICD).<bold>Purpose: </bold>To evaluate the prognostic value of cardiac MR-LGE for ICM and NICM patients with ICD.<bold>Study Type: </bold>Systematic review and meta-analysis.<bold>Population: </bold>A total of 33 studies of 3457 patients were included.<bold>Field Strength: </bold>1. 5T and 3.0T, LGE.<bold>Assessment: </bold>PubMed, Cochrane Library, EMBASE, and Web of Science were systematically searched for studies reporting LGE in ICM or NICM patients with ICD implantation with several kinds of endpoints: MACE, life-threatening arrhythmia, cardiovascular mortality, and all-cause mortality.<bold>Statistical Tests: </bold>A meta-analysis was performed using a random-effects model to calculate odds ratios or standard mean differences (SMDs) for binary and continuous data.<bold>Results: </bold>MR-LGE was positive in 1923 (55.6%) of ICM and NICM patients. LGE-present patients were more likely to have life-threatening arrhythmia (odds ratio [OR]: 5.1; 95% confidence interval [CI]: 3.8-6.8), MACE (OR: 5.2; 95% CI: 3.8-6.9), cardiovascular mortality (OR: 2.4; 95% CI: 1.2-4.6), and all-cause mortality (OR: 2.1; 95% CI: 1.3-3.4) compared with those without LGE. Moreover, ICM and NICM patients with LGE both had increased life-threatening arrhythmia (OR: 4.6; 95% CI: 2.7-8.0; OR: 5.2; 95% CI: 3.6-7.8, respectively) and MACE (OR: 4.7; 95% CI: 2.8-7.9; OR: 4.7; 95% CI: 2.7-8.1, respectively).<bold>Data Conclusion: </bold>The presence of MR-LGE may worsen the prognosis for adverse cardiovascular events in both ICM and NIMC patients who benefit more from ICDs.<bold>Level Of Evidence: </bold>3 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2020;51:1422-1439.
- Subjects
HEART failure patients; IMPLANTABLE cardioverter-defibrillators; ARRHYTHMIA; META-analysis; GADOLINIUM; RESEARCH; PREDICTIVE tests; RESEARCH methodology; SYSTEMATIC reviews; PROGNOSIS; CONTRAST media; MEDICAL cooperation; EVALUATION research; CHEMICAL elements; COMPARATIVE studies; RESEARCH funding; HEART failure
- Publication
Journal of Magnetic Resonance Imaging, 2020, Vol 51, Issue 5, p1422
- ISSN
1053-1807
- Publication type
journal article
- DOI
10.1002/jmri.26982