Prognostic impact of late gadolinium enhancement at the right ventricular insertion points in non-ischemic dilated cardiomyopathy.

Eduard Claver , Andrea Di Marco, Pamela Frances Brown, Joshua Bradley, Gaetano Nucifora, Alejandro Ruiz-Majoral , Paolo Domenico Dallaglio, Marcos Rodriguez , Jisela Viedma , Josep Comin-Colet, Ignasi Anguera, Christopher Miller, Matthias Schmitt

Research output: Contribution to journalArticlepeer-review


To evaluate the baseline characteristics and the prognostic implications associated with late gadolinium enhancement limited to the right ventricular insertion points (IP-LGE) or present at both the right ventricular insertion points and the left ventricle (IP&LV-LGE) in non-ischemic dilated cardiomyopathy (DCM).
Methods and results
Retrospective observational multicenter cohort study including 1165 consecutive patients with DCM evaluated by cardiac magnetic resonance. The primary endpoint included appropriate defibrillator therapies, sustained ventricular tachycardia, resuscitated cardiac arrest or sudden death. The secondary outcome encompassed heart failure hospitalizations, heart transplant, left ventricular assist device implantation and end-stage heart failure death.
IP-LGE was found in 72 patients (6%), who had clinical characteristics closer to LGE- than to LGE+ patients. During follow-up (median 36 months), none of the IP-LGE patients experienced the primary endpoint. The cumulative incidence of the primary endpoint was similar between IP-LGE and LGE- patients (p=1) while IP-LGE had significantly lower cumulative incidence as compared to LGE+ patients (p<0.001). As compared to IP-LGE patients, the cumulative incidence of the secondary endpoint was similar in LGE- cases (p=0.86) but tended to be higher in LGE+ patients (p=0.06). Both clinical characteristics and outcomes were similar between IP&LV-LGE patients and the rest of LGE+ cases.
In a large cohort of DCM patients, IP-LGE was associated with similar outcome as compared to LGE- patients and with significant lower risk of ventricular arrhythmias and sudden death as compared to LGE+ cases. Patients with IP&LV-LGE had clinical characteristics and outcomes similar to the rest of LGE+ cases.
Original languageEnglish
JournalEuropean heart journal. Cardiovascular Imaging
Publication statusAccepted/In press - 26 May 2022


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