Prognostic value of late enhancement in cardiac magnetic resonance in patients with dilated cardiomyopathy: a meta-analysis
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KeywordsPublic Health Confidence Interval Clinical Trial Clinical Outcome Cardiomyopathy
To systematically review the prognostic value of late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) in patients with dilated cardiomyopathy (DCM).
A literature search was performed on Medline and Embase for original articles estimating the LGE prognostic value in patients with DCM. Original articles had to assess mortality for cardiac and non-cardiac causes, sudden cardiac death, sudden death avoided, and hospitalization for cardiac failure. Heterogeneity (I2) was evaluated using the Cochrane Q statistics: P-value <0.100 were considered significant. Pooled odd ratio (OR) and 95% confidence interval (CI: 95%) were calculated using Comprehensive Meta-Analysis.
Out of 691 articles initially retrieved, 6 prospective clinical trials were selected for a total of 1,017 patients. All analyzed studies were performed using a 1.5-T MR unit. LGE was positively correlated with all considered clinical outcomes. Pooled mortality for all causes showed I2=33% p = 0.202) and OR=2.6 (95%CI 1.7-4.0; p<0.001); hospitalization for cardiac failure showed I2=24% (p=0.257) and OR=2.7 (95%CI 1.8-4.1; p<0.001); sudden cardiac death showed I2=0% (p=0.895) and OR=3.2 (95%CI 1.6-6.3; p=0.001); death for cardiac causes showed I2=0% (p=0.782) and OR=3.5 (95%CI 2.2-5.7; p<0.001); sudden death avoided showed I2=0% (p=0.815) and OR=6.3 (95%CI 3.4-11.6; p<0.001).
LGE at CMR in patients with CMD is closely related to a more negative prognosis if compare to patients without LGE.
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