title: Myocardial fibrosis on cardiac magnetic resonance and cardiac outcomes in hypertrophic cardiomyopathy: a meta-analysis.
abstract: OBJECTIVE
  Late gadolinium enhancement (LGE) on cardiac MRI that indicates the extent of myocardial fibrosis in hypertrophic cardiomyopathy (HCM) is a potential risk factor of sudden cardiac death (SCD) in non-high-risk patients according to conventional clinical markers.
  
  
  METHODS
  The present study was designed to systematically review prospective trials and assess the association between LGE and SCD in HCM. We systematically searched the electronic databases, MEDLINE, PubMed, Embase and Cochrane for prospective cohort studies of the effects of LGE on clinical outcomes (SCD/aborted SCD, all-cause mortality, cardiac and heart failure death) in HCM.
  
  
  RESULTS
  We identified six clinical studies, examining 1414 patients without LGE and 1653 with LGE and an average follow-up of 3.05 years. The incidence of SCD/aborted SCD in patients with HCM and LGE was significantly increased as compared with patients without LGE (OR 2.52, 95% CI 1.44 to 4.4, p=0.001). The all-cause mortality and cardiac death rates were also significantly increased in patients with LGE. The extent of LGE was not significantly related to the risk of SCD.
  
  
  CONCLUSIONS
  LGE is significantly associated with SCD risk, cardiac mortality and all-cause mortality in patients with non-high-risk HCM according to conventional risk factors.
authors.affiliation: Division of Cardiology, Wayne State University/Detroit Medical Center, Detroit, Illinois, USA.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Briasoulis
authors.affiliation: Division of Cardiology, Wayne State University/Detroit Medical Center, Detroit, Illinois, USA.
authors.forename: Sagar
authors.initials: S
authors.lastname: Mallikethi-Reddy
authors.affiliation: Division of Cardiology, Wayne State University/Detroit Medical Center, Detroit, Illinois, USA.
authors.forename: Mohan
authors.initials: M
authors.lastname: Palla
authors.affiliation: Division of Cardiology, Wayne State University/Detroit Medical Center, Detroit, Illinois, USA.
authors.forename: Issa
authors.initials: I
authors.lastname: Alesh
authors.affiliation: Division of Cardiology, Wayne State University/Detroit Medical Center, Detroit, Illinois, USA.
authors.forename: Luis
authors.initials: L
authors.lastname: Afonso
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000401:mortality / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D002423:Cause of Death; D016009:Chi-Square Distribution; D003287:Contrast Media; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control; D005260:Female; D005355:Fibrosis; D006333:Heart Failure / Q000401:mortality / Q000473:pathology; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D003287:Contrast Media