Skip to content

Advertisement

Volume 18 Supplement 1

19th Annual SCMR Scientific Sessions

  • Oral presentation
  • Open Access

Prevalence and prognosis of non-ischemic patterns of late gadolinium enhancement in older adults by cardiovascular MR in the ICELAND-MI study

  • 7,
  • 1, 2,
  • 3, 7,
  • 4,
  • 5, 7,
  • 6, 7,
  • 1,
  • 7,
  • 1,
  • 8,
  • 8,
  • 1 and
  • 7
Journal of Cardiovascular Magnetic Resonance201618 (Suppl 1) :O61

https://doi.org/10.1186/1532-429X-18-S1-O61

  • Published:

Keywords

  • Heart Failure
  • Myocardial Infarction
  • Late Gadolinium Enhancement
  • Aortic Root
  • Minor Pattern

Background

Late gadolinium enhancement (LGE) can detect and discriminate myocardial scar/fibrosis of ischemic and non-ischemic etiologies. Our objective was to determine the prevalence and prognosis for ischemic and non-ischemic patterns of LGE in a community-based sample of older adults.

Methods

ICELAND-MI is a nested cohort of the Age, Gene/Environment Susceptibility-Reykjavik Study of community-dwelling older adults that intentionally over-sampled diabetic subjects. After excluding subjects with pre-existing heart failure, the cohort size was 900. CMR was used to detect myocardial infarction (MI), major patterns of non-ischemic patterns of LGE as defined by Vöhringer (Herz 2007;32:129-37), and minor patterns of non-ischemic LGE including LGE near the aortic root, mitral annulus, or right ventricular insertion points. The composite end-point was adjudicated hospitalization for heart failure and death.

Results

The median age was 76 (IQR 72-81), 48% were male, and 35% had diabetes. The prevalence of MI, major non-ischemic patterns of LGE, and minor non-ischemic patterns of LGE were 23.4%(N = 211), 6.0%(N = 54), and 26.4%(N = 238) respectively. Major non-ischemic LGE demonstrated the highest risk (HR 3.5, p < 0.0001, Figure 1), MI had similar risk (HR 2.5, p < 0.0001), and minor non-ischemic LGE had lower but significantly higher risk (HR1.5, p = 0.03) compared to those without LGE. Controlling for age, gender, LVEF, diabetes, and hypertension, major non-ischemic LGE remained strongly predictive of the composite endpoint (HR 2.3, p = 0.001) while minor non-ischemic patterns of LGE were of borderline significance (p = 0.07).
Figure 1
Figure 1

Kaplan-Meier Event Rates for Subjects with Major Non-ischemic LGE, MI, Minor Non-ischemic LGE versus Normal LGE.

Conclusions

Subjects with major non-ischemic LGE patterns are at increased risk of developing heart failure and death.

Authors’ Affiliations

(1)
Icelandic Heart Association, Kopavogur, Iceland
(2)
Public Health Sciences, University of Iceland, Reykjavik, Iceland
(3)
Gentofte Hospital, Copenhagen, Iceland
(4)
University of Iceland, Reykjavik, Iceland
(5)
Division of Cardiology, UPMC Heart and Vascular Institute, Pittsburgh, PA, USA
(6)
Cardiology, St. Francis Hospital, Roslyn, NY, USA
(7)
NIH/NHLBI, Bethesda, MD, USA
(8)
National Institute on Aging, NIH, Bethesda, MD, USA

Copyright

Advertisement