Long-Term Prognostic Value of Late Gadolinium-Enhanced Magnetic Resonance Imaging in Patients With and Without Left Ventricular Dysfunction Undergoing Coronary Artery Bypass Grafting

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• 作者：Seung-Ah Lee ; MD^a ; ^b ; Yeonyee E. Yoon ; MD^a ; ^c ; ^{yeonyeeyoon@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Jung-Eun Kim ; MD^a ; Jin Joo Park ; MD^a ; ^c ; Il-Young Oh ; MD^a ; ^c ; Chang-Hwan Yoon ; MD^a ; ^c ; Jung-Won Suh ; MD^a ; ^c ; Jun-Sung Kim ; MD^d ; Eun Ju Chun ; MD^e ; Young-Suk Cho ; MD^a ; ^c ; Tae-Jin Youn ; MD^a ; ^c ; Cheong Lim ; MD^d ; Goo-Young Cho ; MD^a ; ^c ; In-Ho Chae ; MD^a ; ^c ; Kay-Hyun Park ; MD^d ; Dong-Ju Choi ; MD^a ; ^c ; Sang Il Choi ; MD^e
• 刊名：The American Journal of Cardiology
• 出版年：2016
• 出版时间：1 December 2016
• 年：2016
• 卷：118
• 期：11
• 页码：1647-1654
• 全文大小：1025 K

文摘

The value of late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) for the prediction of functional recovery after surgical revascularization has been previously established. However, the impact of LGE-MRI on the long-term prognosis after coronary artery bypass grafting (CABG) remains incompletely understood. Therefore, we aimed to evaluate the long-term prognostic value of LGE-MRI, based on the presence or absence of left ventricular (LV) dysfunction, in patients with coronary artery disease undergoing CABG. One hundred forty-six consecutive patients underwent cine- and LGE-MRI before CABG. Adverse cardiac events included cardiac death, nonfatal myocardial infarction, heart failure, and unstable angina. A 3-year landmark analysis of the primary end point was also performed for patients surviving beyond 3 years after CABG. During a median follow-up of 9.4 years, 44 patients (30%) experienced adverse cardiac events. Although a LV ejection fraction <50% was associated only with adverse cardiac events at 3 years after CABG, LGE was associated with a worse outcome both at and beyond 3 years after CABG. In the overall study population, LGE presence (adjusted hazard ratio [HR] 2.58; p = 0.027), score (adjusted HR 1.06; p <0.001), and extent (adjusted HR 1.08; p <0.001) were independent predictors of adverse cardiac events. Moreover, in both the LV ejection fraction <50% and ≥50% groups, the LGE extent was an independent predictor of adverse cardiac events. In conclusion, our qualitative and quantitative analyses of LGE-MRI provide long-term prognostic information after surgical revascularization. The LGE extent was a strong predictor of adverse cardiac events, independent of the LV function.