Prognostic value of late gadolinium enhancement in dilated cardiomyopathy patients: a meta-analysis

AIM: To evaluate the association between late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) and major adverse events in dilated cardiomyopathy (DCM) patients. MATERIALS AND METHODS: Databases, including PubMed, Ovid, and EMBASE, were searched for studies evaluating LGE at CMR in DCM patient prognostication. Clinical outcomes were analysed using fixed-effects models or, in cases of significant heterogeneity, random-effects models. RESULTS: In the meta-analysis of 13 studies on 1675 DCM patients with a mean follow-up of 3 years, LGE is associated with all-cause mortality (pooled odds ratio, 3.43 [95% confidence interval, 2.26-5.22], p<0.00001), cardiac death/transplantation (3.65 [1.80-7.40], p=0.0003), hospitalisation for heart failure (2.87 [1.53-5.39], p=0.001), major arrhythmia events (sudden cardiac death, sustained ventricular tachycardia or fibrillation, appropriate implantable cardioverter-defibrillator (ICD) discharge/pacing, and syncope: 4.24 [2.95-6.08], p<0.00001), and sudden cardiac death (3.33 [1.80-6.17], p=0.0001). CONCLUSION: LGE in DCM patients appears to be associated with mortality and major cardiac events, underscoring its potential as an independent index for risk stratification and treatment guidance. (C) 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.