Imperial College London


Faculty of MedicineNational Heart & Lung Institute

Professor of Cardiology



+44 (0)20 7351 8810d.pennell




CMR UnitRoyal BromptonRoyal Brompton Campus






BibTex format

author = {Halliday, BP and Baksi, AJ and Gulati, A and Ali, A and Newsome, S and Izgi, C and Arzanauskaite, M and Lota, A and Tayal, U and Vassiliou, V and Gregson, J and Alpendurada, F and Frenneaux, M and Cook, S and Cleland, J and Pennell, D and Prasad, S},
doi = {10.1016/j.jcmg.2018.07.015},
journal = {JACC: Cardiovascular Imaging},
pages = {1645--1655},
title = {Outcome in dilated cardiomyopathy related to the extent, location and pattern of late gadolinium enhancement},
url = {},
volume = {12},
year = {2019}

RIS format (EndNote, RefMan)

AB - ObjectivesThis study sought to investigate the association between the extent, location, and pattern of late gadolinium enhancement (LGE) and outcome in a large dilated cardiomyopathy (DCM) cohort.BackgroundThe relationship between LGE and prognosis in DCM is incompletely understood.MethodsWe examined the association between LGE and all-cause mortality and a sudden cardiac death (SCD) composite based on the extent, location, and pattern of LGE in DCM.ResultsOf 874 patients (588 men, median age 52 years) followed for a median of 4.9 years, 300 (34.3%) had nonischemic LGE. Estimated adjusted hazard ratios for patients with an LGE extent of 0 to 2.55%, 2.55% to 5.10%, and >5.10%, respectively, were 1.59 (95% confidence interval [CI]: 0.99 to 2.55), 1.56 (95% CI: 0.96 to 2.54), and 2.31 (95% CI: 1.50 to 3.55) for all-cause mortality, and 2.79 (95% CI: 1.42 to 5.49), 3.86 (95% CI: 2.09 to 7.13), and 4.87 (95% CI: 2.78 to 8.53) for the SCD end-point. There was a marked nonlinear relationship between LGE extent and outcome such that even small amounts of LGE predicted a substantial increase in risk. The presence of septal LGE was associated with increased mortality, but SCD was most associated with the combined presence of septal and free-wall LGE. Predictive models using LGE presence and location were superior to models based on LGE extent or pattern.ConclusionsIn DCM, the presence of septal LGE is associated with a large increase in the risk of death and SCD events, even when the extent is small. SCD risk is greatest with concomitant septal and free-wall LGE. The incremental value of LGE extent beyond small amounts and LGE pattern is limited.
AU - Halliday,BP
AU - Baksi,AJ
AU - Gulati,A
AU - Ali,A
AU - Newsome,S
AU - Izgi,C
AU - Arzanauskaite,M
AU - Lota,A
AU - Tayal,U
AU - Vassiliou,V
AU - Gregson,J
AU - Alpendurada,F
AU - Frenneaux,M
AU - Cook,S
AU - Cleland,J
AU - Pennell,D
AU - Prasad,S
DO - 10.1016/j.jcmg.2018.07.015
EP - 1655
PY - 2019///
SN - 1936-878X
SP - 1645
TI - Outcome in dilated cardiomyopathy related to the extent, location and pattern of late gadolinium enhancement
T2 - JACC: Cardiovascular Imaging
UR -
UR -
UR -
VL - 12
ER -