Heart failure & cardiomyopathies
Clinical Implications of Transmural Late Gadolinium Enhancement in Genotype-Positive Arrhythmogenic and Dilated Cardiomyopathy
Authors' conclusion
Transmural LGE identifies a small but high-risk subset of genotype-positive ACM/DCM, particularly among patients with LMNA and DSP variants, with significantly increased arrhythmic and heart failure risk.
Study context
- Population
- Genotype-positive patients with nonischemic arrhythmogenic cardiomyopathy (ACM)/dilated cardiomyopathy (DCM) with cardiac magnetic resonance imaging and no significant coronary artery diseasewith cardiac magnetic resonance imaging and no significant coronary artery disease, of 1,379 genotype-positive patients with ACM/DCM
- Participants
- 711 patients
- Comparison
- Transmural late gadolinium enhancement (LGE) compared with nontransmural or absent LGE
- transmural LGEn = 33
Methodological detailsKaplan-Meier and age-adjusted Cox regression analyses
- Kaplan-Meier and age-adjusted Cox regression analyses
Main finding
As reported in the abstract
Prevalence of transmural LGE
Transmural LGE present
5%
33/711
Further findings
MVA events
AHF therapies
| Outcome | HR | P value |
|---|---|---|
| Thromboembolic events, atrial fibrillation, and implantable cardioverter-defibrillator implantation · higher rates with transmural LGE | all P ≤ 0.003 | |
| Composite endpoint of MVA/AHF — transmural LGE vs nontransmural LGE · age-adjusted · age-adjusted models | 1.9 | P = 0.03 |
| Composite endpoint of MVA/AHF — transmural LGE vs no LGE · age-adjusted · age-adjusted models | 2.9 | P = 0.0005 |
- Major ventricular arrhythmic (MVA) events: P < 0.05
- Advanced heart failure (AHF) therapies: P < 0.05
Original publication
Clinical Implications of Transmural Late Gadolinium Enhancement in Genotype-Positive Arrhythmogenic and Dilated Cardiomyopathy. JACC Clin Electrophysiol. Published 23 July 2026. doi:10.
Summarised from the published abstract; every number is checked against it