Heart failure & cardiomyopathiesCohort study
Stress cardiovascular magnetic resonance (CMR) ischaemic burden and long-term mortality in left ventricular systolic dysfunction: a multicentre registry study
- prospective multicentre registry
- consecutive patients
- three French centres
Authors' conclusion
In patients with LVEF < 50%, ischaemic burden on stress CMR is independently associated with long-term mortality beyond clinical factors, LVEF and LGE. Integrating ischaemia and scar metrics provides incremental prognostic information that may aid risk stratification using stress CMR in LV systolic dysfunction.
Study context
- Population
- Consecutive patients undergoing vasodilator stress perfusion CMR with CMR-derived LVEF < 50%, 2008–2479% men, age 66 ± 12 years, mean LVEF 42 ± 7%
- Participants
- 5,977 patients
- Exposure
- Incremental prognostic value of ischaemia and late gadolinium enhancement (LGE) beyond clinical factors and LVEF
- Outcome
- All-cause mortality
- Follow-up
- Median 9 years
Main finding
As reported in the abstract
HR per segment
1.11 per segment
95% CI 1.06–1.15
P < 0.001
Per segment, as printed
- Patients who died
- 1343 patients (22%)
Observational data: associations, not effects.
Further findings
Inducible ischaemia prevalence
- Inducible ischaemia present
- 19%
- Mean ischaemic extent
- 2.4 ± 1.2 segments
Incremental prognostic value of adding ischaemia and LGE to clinical factors and LVEF
- Global χ2
- 707 to 728
- Net reclassification improvement (NRI)
- 0.217
- Integrated discrimination improvement (IDI)
- 0.004
- all P < 0.001
LVEF subgroups (40-50% and <40%)
- Findings were consistent across LVEF subgroups
Outcomes by subsequent revascularization status among patients with ischaemia (secondary analysis)
- Outcomes differed by subsequent revascularization status
- observational and hypothesis-generating
Original publication
Summarised from the published abstract; every number is checked against it