Combination of late gadolinium enhancement and genotype improves prediction of prognosis in non-ischaemic dilated cardiomyopathy
Mirelis, Jesús G. (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Escobar-Lopez, Luis (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Ochoa, Juan Pablo (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Espinosa, María Ángeles (Hospital General Universitario Gregorio Marañón)
Villacorta, Eduardo (Universidad de Salamanca)
Navarro Peñalver, Marina (Hospital Universitario Virgen de la Arrixaca (Múrcia))
Casas, Guillem (Hospital Universitari Vall d'Hebron)
Mora-Ayestarán, Nerea (Complejo Hospitalario de Navarra)
Barriales-Villa, Roberto (Universidade da Coruña)
Mogollón-Jiménez, María Victoria (Complejo Hospitalario Universitario de Cáceres)
García-Pinilla, José Manuel (Hospital Universitario Virgen de la Victoria (Màlaga, Andalusia))
García-Granja, Pablo Elpidio (Hospital Clínico Universitario de Valladolid)
Climent, Vicente (Hospital General Universitario de Alicante (Alacant, País Valencià))
Palomino-Doza, Julian (Hospital 12 de Octubre (Madrid))
García-Álvarez, Ana (Hospital Clínic i Provincial de Barcelona)
Álvarez-Barredo, María (Complejo Hospitalario Universitario de Santiago de Compostela)
Cabrera-Borrego, Eva (Hospital Universitario Virgen de las Nieves (Granada))
Ripoll-Vera, Tomás (Hospital Universitari Son Llàtzer (Palma de Mallorca, Balears))
Peña-Peña, María Luisa (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Rodríguez-González, Elena (Hospital General Universitario Gregorio Marañón)
Gallego-Delgado, María (Gerencia Regional de Salud de Castilla y León (SACYL))
Gonzalez-Carrillo, Josefa (Hospital Universitario Virgen de la Arrixaca (Múrcia))
Fernández-Ávila, Ana (Hospital General Universitario Gregorio Marañón)
Rodriguez-Palomares, Jose F (Hospital Universitari Vall d'Hebron)
Brugada, Ramon (Hospital Universitari de Girona Doctor Josep Trueta)
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Dominguez, Fernando (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
García-Pavía, Pablo (Universidad Autónoma de Madrid)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Genotype and left ventricular scar on cardiac magnetic resonance (CMR) are increasingly recognized as risk markers for adverse outcomes in non-ischaemic dilated cardiomyopathy (DCM). We investigated the combined influence of genotype and late gadolinium enhancement (LGE) in assessing prognosis in a large cohort of patients with DCM. Outcomes of 600 patients with DCM (53. 3 ± 14. 1 years, 66% male) who underwent clinical CMR and genetic testing were retrospectively analysed. The primary endpoints were end-stage heart failure (ESHF) and malignant ventricular arrhythmias (MVA). During a median follow-up of 2. 7 years (interquartile range 1. 3-4. 9), 24 (4. 00%) and 48 (8. 00%) patients had ESHF and MVA, respectively. In total, 242 (40. 3%) patients had pathogenic/likely pathogenic variants (positive genotype) and 151 (25. 2%) had LGE. In survival analysis, positive LGE was associated with MVA and ESHF (both, p < 0. 001) while positive genotype was associated with ESHF (p = 0. 034) but not with MVA (p = 0. 102). Classification of patients according to genotype (G+/G−) and LGE presence (L+/L−) revealed progressively increasing events across L−/G−, L−/G+, L+/G− and L+/G+ groups and resulted in optimized MVA and ESHF prediction (p < 0. 001 and p = 0. 001, respectively). Hazard ratios for MVA and ESHF in patients with either L+ or G+ compared with those with L−/G− were 4. 71 (95% confidence interval: 2. 11-10. 50, p < 0. 001) and 7. 92 (95% confidence interval: 1. 86-33. 78, p < 0. 001), respectively. Classification of patients with DCM according to genotype and LGE improves MVA and ESHF prediction. Scar assessment with CMR and genotyping should be considered to select patients for primary prevention implantable cardioverter-defibrillator placement. Non-ischaemic dilated cardiomyopathy (NI DCM) patients with positive genotype and/or late gadolinium enhancement (LGE) show increased risk of ventricular arrhythmias and end-stage heart failure (ESHF) during follow-up. CI, confidence interval; HR, hazard ratio; LVEF, left ventricular ejection fraction; MVA, malignant ventricular arrhythmia.
Ajuts:	Instituto de Salud Carlos III PI19/01283
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Cardiac magnetic resonance ; Dilated cardiomyopathy ; End-stage heart failure ; Genotype ; Late gadolinium enhancement ; Sudden cardiac death
Publicat a:	European Journal of Heart Failure, Vol. 24 (may 2022) , p. 1183-1196, ISSN 1879-0844

DOI: 10.1002/ejhf.2514
PMID: 35485241

14 p, 2.0 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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