Volume 51, Issue 5 pp. 1422-1439

Original Research

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

Ting Yue MD,

Ting Yue MD

Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Bing-Hua Chen MD,

Bing-Hua Chen MD

orcid.org/0000-0002-2718-8416

Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Lian-Ming Wu MD, PhD,

Corresponding Author

Lian-Ming Wu MD, PhD

[email protected]

orcid.org/0000-0001-7381-5436

Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Address reprint requests to: L.M.W., J.R.X, Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 PuJian Road, Shanghai 200127, P.R. China. E-mail: [email protected] or [email protected] or J.P., Department of Cardiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 PuJian Road, Shanghai 200127, P.R. China. E-mail: [email protected]Search for more papers by this author

Jian-Rong Xu MD, PhD,

Corresponding Author

Jian-Rong Xu MD, PhD

[email protected]

Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Jun Pu MD, PhD,

Corresponding Author

Jun Pu MD, PhD

[email protected]

Department of Cardiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Ting Yue MD,

Ting Yue MD

Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Search for more papers by this author

Bing-Hua Chen MD,

Bing-Hua Chen MD

orcid.org/0000-0002-2718-8416

Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Search for more papers by this author

Lian-Ming Wu MD, PhD,

Corresponding Author

Lian-Ming Wu MD, PhD

[email protected]

orcid.org/0000-0001-7381-5436

Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Jian-Rong Xu MD, PhD,

Corresponding Author

Jian-Rong Xu MD, PhD

[email protected]

Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Jun Pu MD, PhD,

Corresponding Author

Jun Pu MD, PhD

[email protected]

Department of Cardiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

First published: 11 November 2019

https://doi.org/10.1002/jmri.26982

Citations: 3

The first two authors contributed equally to this work.

Contract grant sponsor: National Natural Science Foundation of China; Contract grant numbers: 81873886, 81873887; Contract grant sponsor: Shanghai Municipal Commission of Health and Family Planning excellent young talent program; Contract grant number: 2017YQ031 (all to L.M.W. and J.R.X.).

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Abstract

Background

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).

Purpose

To evaluate the prognostic value of cardiac MR-LGE for ICM and NICM patients with ICD.

Study Type

Systematic review and meta-analysis.

Population

A total of 33 studies of 3457 patients were included.

Field Strength

1. 5T and 3.0T, LGE.

Assessment

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.

Statistical Tests

A meta-analysis was performed using a random-effects model to calculate odds ratios or standard mean differences (SMDs) for binary and continuous data.

Results

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).

Data Conclusion

The presence of MR-LGE may worsen the prognosis for adverse cardiovascular events in both ICM and NIMC patients who benefit more from ICDs.

Level of Evidence: 3

Technical Efficacy Stage: 3

J. Magn. Reson. Imaging 2020;51:1422–1439.

Conflict of Interest

Nothing to report.

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Citing Literature

Volume51, Issue5

May 2020

Pages 1422-1439

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

Abstract

Background

Purpose

Study Type

Population

Field Strength

Assessment

Statistical Tests

Results

Data Conclusion

Conflict of Interest

References

Citing Literature

References

Information

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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

Abstract

Background

Purpose

Study Type

Population

Field Strength

Assessment

Statistical Tests

Results

Data Conclusion

Conflict of Interest

References

Citing Literature

References

Related

Information