Abstract 4191: Prognostic Significance of Normal Combined Stress, Delayed Enhancement, and Functional Cardiac Magnetic Resonance Imaging

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Scott Bingham ◽  
Rory Hachamovitch
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Prognostic Significance ◽  
Delayed Enhancement ◽  
Stress Perfusion ◽  
Cardiac Events ◽  
History Of ◽  
Artery Disease ◽  
Event Rates

Background: Combined adenosine stress perfusion (STRESS), myocardial delayed enhancement (MDE), and ventricular wall motion (WM) by cardiac magnetic resonance (CMR) is a promising approach to further risk stratification in patients with intermediate pre-test clinical cardiovascular risk. The prognosis conferred by normal (NL) STRESS, MDE, and WM CMR is unknown. Methods: 1,002 consecutive patients underwent combined CMR including STRESS by gadolinium first-pass perfusion, MDE, and cine WM for suspicion of coronary artery disease (CAD) or myocardial ischemia. 577 patients had NL STRESS, 607 had NL MDE, 544 had NL WM, and 448 had NL combined CMR. 70% had no history of CAD. Follow up was performed at a mean 31 (range 12– 62) months after CMR for cardiac death (CD) all-cause death (ACD) and non-fatal myocardial infarction (MI). Results: NL combined CMR resulted in 0.6% rate of CD per year of follow up (0.3% if no CAD history, and 1.4% with CAD history). Rates for ACD and ACD plus MI were 1.9% and 2.0%. Similar event rates were observed when each component of combined CMR was considered separately. Conclusion: Normal STRESS, MDE, and WM CMR, both singly or in combination, confer a low risk of subsequent cardiac events. Event Rate % per Year of Follow Up

P597Clinical and prognostic correlates of volume/time curve at cardiac magnetic resonance in patients with non-ischemic heart failure and left bundle branch block

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Aimo ◽  
A Barison ◽  
A Valleggi ◽  
S Salerni ◽  
R De Caterina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Bundle Branch Block ◽  
Prognostic Significance ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Time Curve ◽  
Bundle Branch Block

Abstract Background In patients with non-ischaemic systolic heart failure (HF) and left bundle branch block (LBBB), the systolic phase of the left ventricular (LV) volume/time (V/t) curve at cardiac magnetic resonance (CMR) can display a wide or a narrow pattern (WP/NP). The clinical and prognostic significance of these patterns are currently unknown. Methods Consecutive patients with systolic non-ischaemic HF (LV ejection fraction <50%) and LBBB were enrolled. They underwent a baseline evaluation including CMR, and were periodically re-evaluated during follow-up. The endpoint was a composite of cardiovascular death, heart failure (HF)-related event, and ventricular arrhythmias requiring defibrillator shock. Results Out of 101 patients (mean age 64±11 years, males 50%), NP was found in 29 and WP in 72, with no difference in QRS duration. Patients with WP had worse clinical presentation and greater LV volumes, but similar LGE prevalence, extent or distribution. The WP subgroup displayed a greater maximal dyssynchrony time, expressed both as absolute duration (192±80 vs. 143±65 ms, P<0.001), and as percentage of the RR interval (25±11% vs. 8±4%, p<0.001). Even the systolic dyssynchrony index was higher in patients with WP (13±4 vs. 7±3%, p<0.001). The contractility index was lower in patients with the WP (2.6±1.2 vs 3.2±1.7, p<0.05). Over a median follow-up duration of 44 months (interquartile interval 23–59), only WP (p=0.029) and NT-proBNP (p=0.004) demonstrated an independent prognostic value for cardiac events. Conclusions In patients with non-ischaemic systolic HF and LBBB, the WP of V/t curves identifies a subgroup of patients with greater LV dyssynchrony, worse clinical conditions and prognosis.

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