Late gadolinium enhancement by cardiovascular magnetic resonance provides prognostic information in symptomatic alcoholic cardiomyopathy

Background

Previous studies have demonstrated that late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR)predicted independently cardiac adverse outcomes in dilated cardiomyopathy (DCM). ACM patients did not have a better outcome than DCM and prognosis was poorer after development of heart failure. There is no report about the association between alcoholic cardiomyopathy (ACM) outcomes and LGE.

Methods

70 consecutive ACM patients from July 2008 to December 2010 were examined with LGE during CMR. The mean follow-up time was 42.3±17.5 months after CMR. Cardiac events include cardiac death, implantable cardioverter-defibrillator (ICD) discharge, hospitalisation for decompensated congestive heart failure (CHF) and heart transplantation.

Results

Of the 70 patients, myocardial fibrosis visualized by LGE was detected in 24(34.3%) patients. During the follow-up period, most events (n=9) were related to hospitalisation for decompensated CHF in the total 13 cardiac events. The incidence of cardiac events was significantly higher in patients with LGE than that without LGE (37.5% vs. 8.7%, P=0.003). When entered into multivariate Cox regression analysis, the presence of LGE yields hazard ratio (HR) of 4.62 (95% CI, 1.4 to 15.4) for cardiac events (P=0.007), the extent of LGE also retains its independent predictive value in LGE (+) patients with HR of 1.13 (95% CI, 1.04 to 1.22, P =0.003).

Conclusions

In patients with symptomatic ACM, the presence of LGE determined by CMR is a strong independent predictor of adverse cardiac events.

Funding

This study was supported by grant No. 81130029 from the key projects of National Natural Science Foundation of China and by grant (Z121107001012114) from Peking Science and Technology Commission.