TY - JOUR
T1 - Prevalence and prognostic value of late gadolinium enhancement on CMR in aortic stenosis
T2 - meta-analysis
AU - Balciunaite, Giedre
AU - Skorniakov, Viktor
AU - Rimkus, Arnas
AU - Zaremba, Tomas
AU - Palionis, Darius
AU - Valeviciene, Nomeda
AU - Aidietis, Audrius
AU - Serpytis, Pranas
AU - Rucinskas, Kestutis
AU - Sogaard, Peter
AU - Glaveckaite, Sigita
N1 - Correction: "The authors are funded by the Research Council of Lithuania".
Balciunaite, G., Skorniakov, V., Rimkus, A. et al. Correction to: Prevalence and prognostic value of late gadolinium enhancement on CMR in aortic stenosis: meta-analysis. Eur Radiol (2020) 30:5222. https://doi.org/10.1007/s00330-020-06818-5
PY - 2020/1
Y1 - 2020/1
N2 - Objectives: The aim of this study was to investigate the prevalence and prognostic value of late gadolinium enhancement (LGE), as assessed by cardiovascular magnetic resonance (CMR) imaging, in patients with aortic stenosis. Methods and results: A systematic search of PubMed and EMBASE was performed, and observational cohort studies that analysed the prevalence of LGE and its relation to clinical outcomes in patients with aortic stenosis were included. Odds ratios were used to measure an effect of the presence of LGE on both all-cause and cardiovascular mortality. Nineteen studies were retrieved, accounting for 2032 patients (mean age 69.8 years, mean follow-up 2.8 years). We found that LGE is highly prevalent in aortic stenosis, affecting half of all patients (49.6%), with a non-infarct pattern being the most frequent type (63.6%). The estimated extent of focal fibrosis, expressed in % of LV mass, was equal to 3.83 (95% CI [2.14, 5.52], p < 0.0001). The meta-analysis showed that the presence of LGE was associated with increased all-cause (pooled OR [95% CI] = 3.26 [1.72, 6.18], p = 0.0003) and cardiovascular mortality (pooled OR [95% CI] = 2.89 [1.90, 4.38], p < 0.0001). Conclusions: LGE by CMR is highly prevalent in aortic stenosis patients and exhibits a substantial value in all-cause and cardiovascular mortality prediction. These results suggest a potential role of LGE in aortic stenosis patient risk stratification. Key Points: • Up to the half of aortic stenosis patients are affected by myocardial focal fibrosis. • Sixty-four percent of focal fibrosis detected by LGE-CMR is non-infarct type. • The presence of focal fibrosis triples all-cause and cardiovascular mortality.
AB - Objectives: The aim of this study was to investigate the prevalence and prognostic value of late gadolinium enhancement (LGE), as assessed by cardiovascular magnetic resonance (CMR) imaging, in patients with aortic stenosis. Methods and results: A systematic search of PubMed and EMBASE was performed, and observational cohort studies that analysed the prevalence of LGE and its relation to clinical outcomes in patients with aortic stenosis were included. Odds ratios were used to measure an effect of the presence of LGE on both all-cause and cardiovascular mortality. Nineteen studies were retrieved, accounting for 2032 patients (mean age 69.8 years, mean follow-up 2.8 years). We found that LGE is highly prevalent in aortic stenosis, affecting half of all patients (49.6%), with a non-infarct pattern being the most frequent type (63.6%). The estimated extent of focal fibrosis, expressed in % of LV mass, was equal to 3.83 (95% CI [2.14, 5.52], p < 0.0001). The meta-analysis showed that the presence of LGE was associated with increased all-cause (pooled OR [95% CI] = 3.26 [1.72, 6.18], p = 0.0003) and cardiovascular mortality (pooled OR [95% CI] = 2.89 [1.90, 4.38], p < 0.0001). Conclusions: LGE by CMR is highly prevalent in aortic stenosis patients and exhibits a substantial value in all-cause and cardiovascular mortality prediction. These results suggest a potential role of LGE in aortic stenosis patient risk stratification. Key Points: • Up to the half of aortic stenosis patients are affected by myocardial focal fibrosis. • Sixty-four percent of focal fibrosis detected by LGE-CMR is non-infarct type. • The presence of focal fibrosis triples all-cause and cardiovascular mortality.
KW - Aged
KW - Aorta/diagnostic imaging
KW - Aortic Valve Stenosis/diagnostic imaging
KW - Cohort Studies
KW - Contrast Media/pharmacokinetics
KW - Female
KW - Gadolinium/pharmacokinetics
KW - Humans
KW - Image Enhancement/methods
KW - Magnetic Resonance Imaging/methods
KW - Male
KW - Middle Aged
KW - Observational Studies as Topic
KW - Prevalence
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85071193124&partnerID=8YFLogxK
U2 - 10.1007/s00330-019-06386-3
DO - 10.1007/s00330-019-06386-3
M3 - Review article
C2 - 31407030
SN - 0938-7994
VL - 30
SP - 640
EP - 651
JO - European Radiology
JF - European Radiology
IS - 1
ER -