Imperial College London
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Rachel Buchan

Faculty of Medicine, National Heart & Lung Institute

Honorary Research Officer
 
 
 
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Contact

 

+44 (0)20 7352 8121 ext 88145rachel.buchan

 
 
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Location

 

2047Sydney StreetRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Lota:2021:10.1016/j.jcmg.2021.05.016,
author = {Lota, AS and Tsao, A and Owen, R and Halliday, BP and Auger, D and Vassiliou, VS and Tayal, U and Almogheer, B and Vilches, S and Al-Balah, A and Patel, A and Mouy, F and Buchan, R and Newsome, S and Gregson, J and Ware, JS and Cook, SA and Cleland, JGF and Pennell, DJ and Prasad, SK},
doi = {10.1016/j.jcmg.2021.05.016},
journal = {JACC: Cardiovascular Imaging},
pages = {2353--2365},
title = {Prognostic significance of non-ischaemic patterns of myocardial fibrosis in patients with normal left ventricular volumes and ejection fraction – the FINALIZE study},
url = {http://dx.doi.org/10.1016/j.jcmg.2021.05.016},
volume = {14},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Non-ischaemic patterns of late gadolinium enhancement (LGE) with normal left ventricular volumes and ejection fraction are increasingly detected on cardiovascular magnetic resonance (CMR) but their prognostic significance, and consequently management, is uncertain. Objectives: To investigate the prognostic significance of LGE in patients without coronary artery disease and with normal range LV volumes and ejection fraction. Methods: Patients with mid-wall/subepicardial LGE and normal LV volumes, wall thickness and ejection fraction on CMR were enrolled and compared to a control group without LGE.57 The primary outcome was actual or aborted sudden cardiac death (SCD). Results: Of 748 patients enrolled, 401 had LGE and 347 did not. Median age was 50 years (IQR 38-61), LV ejection fraction 66% (IQR 62-70) and 287 (38%) were women. Scan indications included chest pain (40%), palpitation (33%) and breathlessness (13%). Nopatient experienced SCD and only one LGE+ patient (0.13%) had an aborted SCD in the 11th follow-up year. Over a median of 4.3years, thirty patients (4.0%) died. All-cause mortality was similar for LGE+/- patients (3.7% vs 4.3%; p=0.71) and was associated with age (H  2.04 per 10-years; 95%CI 1.46-2.79; p<0.001). Twenty-one LGE+ and 4 LGE- patients had an unplanned CV hospitalisation (HR 7.22; 95%CI 4.26-21.17; p<0.0001). Conclusion: There was a low SCD risk during long-term follow-up in patients with LGE but otherwise normal LV volumes and ejection fraction. Mortality was driven by age and not LGE presence, location or extent, although the latter was associated with greater CV hospitalisation for suspected myocarditis and symptomatic ventricular tachycardia.
AU  - Lota,AS
AU  - Tsao,A
AU  - Owen,R
AU  - Halliday,BP
AU  - Auger,D
AU  - Vassiliou,VS
AU  - Tayal,U
AU  - Almogheer,B
AU  - Vilches,S
AU  - Al-Balah,A
AU  - Patel,A
AU  - Mouy,F
AU  - Buchan,R
AU  - Newsome,S
AU  - Gregson,J
AU  - Ware,JS
AU  - Cook,SA
AU  - Cleland,JGF
AU  - Pennell,DJ
AU  - Prasad,SK
DO  - 10.1016/j.jcmg.2021.05.016
EP  - 2365
PY  - 2021///
SN  - 1876-7591
SP  - 2353
TI  - Prognostic significance of non-ischaemic patterns of myocardial fibrosis in patients with normal left ventricular volumes and ejection fraction – the FINALIZE study
T2  - JACC: Cardiovascular Imaging
UR  - http://dx.doi.org/10.1016/j.jcmg.2021.05.016
UR  - https://www.sciencedirect.com/science/article/pii/S1936878X21004368?via%3Dihub
UR  - http://hdl.handle.net/10044/1/89874
VL  - 14
ER  -
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