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- Title
Prognostic value of unrecognised myocardial infarction detected by late gadolinium-enhanced MRI in diabetic patients with normal global and regional left ventricular systolic function.
- Authors
Yoon, Yeonyee; Kitagawa, Kakuya; Kato, Shingo; Nakajima, Hiroshi; Kurita, Tairo; Dohi, Kaoru; Ito, Masaaki; Sakuma, Hajime
- Abstract
Objectives: To determine whether the detection of unrecognised myocardial infarction (MI) using late gadolinium-enhanced (LGE)-magnetic resonance imaging (MRI) can provide prognostic information in diabetic patients with normal ECG as well as normal global and regional left ventricular (LV) function. Methods: From 449 diabetic patients who had complete cine- and LGE-MRI, 321 patients with histories of CAD, ischaemic ECG changes and abnormal cine MRI findings (LV ejection fraction <50 % or presence of regional wall motion abnormality) were excluded. The presence and extent of LGE were determined in the remaining 128 patients. Follow-up information was obtained for the occurrence of major adverse cardiovascular events (MACE) defined as cardiac death, acute MI, heart failure, unstable angina and significant ventricular arrhythmias in 120 patients. Results: Of 120 patients, 18 (15 %) had LGE. During follow-up (median, 27 months), six patients with LGE (33.3 %) and four patients without LGE (3.9 %) experienced MACE, resulting in an annualised event rate of 7.7 % and 0.9 %, respectively (log-rank P <0.001). The presence of LGE was associated with an eight-fold increased hazard for MACE (HR, 8.84; P = 0.001). Conclusions: LGE-MRI can detect unrecognised MI and may improve the risk stratification of diabetic patients with no CAD history, normal ECG and normal LV systolic function. Key Points: • Late gadolinium-enhanced magnetic resonance imaging (LGE-MRI) can identify subtle myocardial abnormalities. • LGE-MRI can detect myocardial infarction missed by ECG and cine-MRI. • Unrecognised MI detected by LGE-MRI was associated with adverse cardiac events. • LGE-MRI helps clinicians to assess diabetic patients with unrecognised MI.
- Subjects
MYOCARDIAL infarction; CARDIAC magnetic resonance imaging; ELECTROCARDIOGRAPHY; SYSTOLIC blood pressure; GADOLINIUM; PEOPLE with diabetes; PROGNOSIS
- Publication
European Radiology, 2013, Vol 23, Issue 8, p2101
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-013-2817-y