Purpose: To evaluate the prognostic value of CMR for cardiac events in SS.
Methods: Two hundred and seventy-three SS patients with a thorough clinical assessment underwent CMR imaging using a 1.5 T GE scanner. We quantified biventricular function parameter by steady-state free precession (SSFP) cine images, edema by short inversion time inversion recovery (STIR) T2 images, and macroscopic fibrosis by late gadolinium enhancement (LGE). Patients were followed-up for subsequent cardiac events, including new-onset pulmonary arterial hypertension (PAH), new-onset heart failure (HF), and new-onset severe arrhythmias (sustained ventricular tachycardia or fibrillation).
Results: The mean follow-up was 23.9 ± 17.0 months. During follow-up, a total of 14 cardiac events occurred in 14 different patients (3 new-onset PAH, 5 new-onset HF, 6 ventricular tachycardias). CMR predictors of cardiac events at univariate analysis were left and right ventricular ejection fractions, indexed left and right atrial areas, and LGE (see Table). Myocardial fibrosis by LGE was the only independent predictor at multivariate analysis (hazard ratio 3.175; 95% C.I. 1.021-9.870, see Figure).
Conclusions: Cardiac magnetic resonance anatomical and functional parameters of both the left and right heart have significant prognostic value in patients with SS.