Association of late gadolinium enhancement in cardiac magnetic resonance with heart failure outcomes in patients with non-ischemic cardiomyopathy

Late-gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR) has been found to be associated with increased mortality in patients with non-ischemic cardiomyopathy (NICM). The correlation between LGE and heart failure (HF) hospitalization, referral for heart transplant, and ejection fraction (EF) improvement have not been well established.

This meta-analysis assessed the relationship between LGE in CMR with HF hospitalization, referral for heart transplant and EF improvement in patients with NICM.

We searched the databases for studies reporting the association between LGE in CMR for NICM and HF outcomes including Ovid MEDLINE, EMBASE, Web of Science, and Google Scholar for all studies. The search was not restricted to time or publication status. The minimal follow up duration is one year.

A total of 216 studies resulted from the literature search. A total of 25 studies and 3,039 patients (1,265 with LGE vs 1,774 without LGE) were included; mean follow up is around 33 months (ranging between 13 to 71 months). Our analysis demonstrated that LGE in NICM was associated with increased risk of HF hospitalization (odds ratio 3.38, 95% confidence interval 2.27–5.04; P<0.01), referral for transplant (odds ratio 5.08, 95% confidence interval 2.49–10.35; P<0.01), and lower chance for EF improvement (odds ratio 0.16, 95% confidence interval 0.03–0.85; P 0.03). Heterogeneity is moderate: χ²=49.5, df=21 (P=0.001), I²=57%. (Figures 1 and 2)

Our results suggest that LGE is associated with increased risk of HF hospitalization and referral for heart transplant and lower chance for EF improvement in long-term follow up.

Type of funding sources: None.