Incidence of ischemic late gadolinium enhancement in patients with dilated cardiomyopathy

While LGE patterns in DCM patients typically include intramyocardial and subepicardial distributions, the ischemic pattern of LGE has also been reported in DCM patients without CAD.

Study Design

The study included 611 DCM patients who underwent cardiac magnetic resonance imaging. 

The primary outcome of the study was a composite endpoint of all-cause mortality, major ventricular arrhythmias (MVAs), and heart transplantation (HTx) or ventricular assist device (VAD) implantation.  

Secondary outcomes included a composite of sudden cardiac death or MVAs as well as a composite of death for refractory heart failure, HTx, or VAD implantation. 

Results and Conclusions

Ischemic LGE, typically inferior/inferolateral/anterolateral, was found in 7% of patients without significant CAD or history of myocardial infarction. 

Patients with ischemic LGE were more likely to have hypertension or atrial fibrillation or flutter in comparison to patients with non-ischemic LGE. 

Ischemic LGE was associated with greater risk of the primary endpoint at 5 years in comparison to non-ischemic LGE. 

After adjustment for multiple variables, ischemic LGE remained a predictor of the primary outcome of the study. 

Related Research

Consider these findings from similar research studies:

• LGE at the right ventricular insertion point was not associated with an increased risk of adverse cardiac events and showed better outcomes than LGE located at the left ventricle (Source). 

• In patients with DCM, the presence of LGE was a strong predictor of high-risk patients (Source).