Incremental Value of Late Gadolinium Enhancement by Cardiac MRI in risk stratification of Heart Failure patients with Moderate and Severe LV dysfunction

Abstract Objective This is a prospective study of patients with LVEF ≤ 40%, with the objective of correlating CV events to LGE detected and quantified by CMRI. Methods HF patients with LVEF Results There were 133 HF (72 ICM & 62 NIDCM) patients with a mean age of 54 ± 12 years, mean LVEF of 34 ± 6% and a follow up of 24 ± 3 months. Totally 46 CV events were recorded in 30 patients, 44 in LGE +ve & 2 in LGE-ve groups (HR 17.8, 95% CI-8.03-39.3, P=0.000095). All the 7 deaths were in LGE +ve group. CV events were 22 (30.5%) in ICM group and 8 in NIDCM (13.1%) group (p=0.03). All the 22 ICM patients and 6 of the 8 NIDCM with CV events were LGE +ve. The distribution of CV events amongst LGE +ve and LGE -ve were 35 vs 0 (ICM) and 9 vs 2 (NIDCM); p 30% the corresponding figures were 9 (22.5%) vs 1 (2.8%) and 15 vs 1 respectively. (p=0.02). Conclusion Demonstration of significant LGE by CMRI indicates high risk occurrence of CV events (CV hospitalization, appropriate shocks and total mortality) in NIDCM & ICM patients with LVEF