Feng XY, He WF, Zhang TY, Wang LL, Yang F, Feng YL, Li CP, Li R. Association between late gadolinium enhancement and outcome in dilated cardiomyopathy: A meta-analysis. World J Radiol 2023; 15(11): 324-337 [PMID: 38058605 DOI: 10.4329/wjr.v15.i11.324]
Corresponding Author of This Article
Rui Li, PhD, Doctor, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Maoyuan South Road, Shunqing District, Nanchong 637000, Sichuan Province, China. ddtwg_nsmc@163.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Nov 28, 2023; 15(11): 324-337 Published online Nov 28, 2023. doi: 10.4329/wjr.v15.i11.324
Association between late gadolinium enhancement and outcome in dilated cardiomyopathy: A meta-analysis
Xin-Yi Feng, Wen-Feng He, Tian-Yue Zhang, Ling-Li Wang, Fan Yang, Yu-Ling Feng, Chun-Ping Li, Rui Li
Xin-Yi Feng, Tian-Yue Zhang, Ling-Li Wang, Fan Yang, Yu-Ling Feng, Chun-Ping Li, Rui Li, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Wen-Feng He, Department of Cardiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Co-first authors: Xin-Yi Feng and Wen-Feng He.
Author contributions: Feng XY participated in the study design, contributed to data analysis and interpretation, and drafted the manuscript; He WF contributed to the preparation, editing and review of the manuscript; Zhang TY carried out data acquisition, performed data analysis and interpretation and edited the manuscript; Wang LL, Feng YL, and Li CP carried out data acquisition and performed data analysis and interpretation; Li R contributed to quality control of data and algorithm, and editing and review of the manuscript; All authors read and approved the final manuscript.
Supported bythe Research Grant of the National Natural Science Foundation of China, No. 81801674; Sichuan Province Science and Technology Support Program, No. 2021YJ0242.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui Li, PhD, Doctor, Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Maoyuan South Road, Shunqing District, Nanchong 637000, Sichuan Province, China. ddtwg_nsmc@163.com
Received: August 17, 2023 Peer-review started: August 17, 2023 First decision: September 14, 2023 Revised: September 29, 2023 Accepted: October 23, 2023 Article in press: October 23, 2023 Published online: November 28, 2023 Processing time: 98 Days and 20.3 Hours
Abstract
BACKGROUND
The prognostic value of late gadolinium enhancement (LGE) derived from cardiovascular magnetic resonance (CMR) is well studied, and several new metrics of LGE have emerged. However, some controversies remain; therefore, further discussion is needed, and more precise risk stratification should be explored.
AIM
To investigate the associations between the positivity, extent, location, and pattern of LGE and multiple outcomes in dilated cardiomyopathy (DCM).
METHODS
PubMed, Ovid MEDLINE, and Cochrane Library were searched for studies that investigated the prognostic value of LGE in patients with DCM. Pooled hazard ratios (HRs) and 95% confidence intervals were calculated to assess the role of LGE in the risk stratification of DCM.
RESULTS
Nineteen studies involving 7330 patients with DCM were included in this meta-analysis and covered a wide spectrum of DCM, with a mean left ventricular ejection fraction between 21% and 50%. The meta-analysis revealed that the presence of LGE was associated with an increased risk of multiple adverse outcomes (all-cause mortality, HR: 2.14; arrhythmic events, HR: 5.12; and composite endpoints, HR: 2.38; all P < 0.001). Furthermore, every 1% increment in the extent of LGE was associated with an increased risk of all-cause mortality. Analysis of a subgroup revealed that the prognostic value varied based on different location and pattern of LGE. Additionally, we found that LGE was a stronger predictor of arrhythmic events in patients with greater left ventricular ejection fraction.
CONCLUSION
LGE by CMR in patients with DCM exhibited a substantial value in predicting adverse outcomes, and the extent, location, and pattern of LGE could provide additional information for risk stratification.
Core Tip: The prognostic value of late gadolinium enhancement (LGE) is well studied, and several new metrics of LGE have emerged. However, some controversies remain; therefore, further discussion is needed, and a more precise risk stratification should be explored.
