title: Long-Term Prognostic Value of Late Gadolinium-Enhanced Magnetic Resonance Imaging in Patients With and Without Left Ventricular Dysfunction Undergoing Coronary Artery Bypass Grafting.
abstract: The value of late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) for the prediction of functional recovery after surgical revascularization has been previously established. However, the impact of LGE-MRI on the long-term prognosis after coronary artery bypass grafting (CABG) remains incompletely understood. Therefore, we aimed to evaluate the long-term prognostic value of LGE-MRI, based on the presence or absence of left ventricular (LV) dysfunction, in patients with coronary artery disease undergoing CABG. One hundred forty-six consecutive patients underwent cine- and LGE-MRI before CABG. Adverse cardiac events included cardiac death, nonfatal myocardial infarction, heart failure, and unstable angina. A 3-year landmark analysis of the primary end point was also performed for patients surviving beyond 3 years after CABG. During a median follow-up of 9.4 years, 44 patients (30%) experienced adverse cardiac events. Although a LV ejection fraction <50% was associated only with adverse cardiac events at 3 years after CABG, LGE was associated with a worse outcome both at and beyond 3 years after CABG. In the overall study population, LGE presence (adjusted hazard ratio [HR] 2.58; p = 0.027), score (adjusted HR 1.06; p <0.001), and extent (adjusted HR 1.08; p <0.001) were independent predictors of adverse cardiac events. Moreover, in both the LV ejection fraction <50% and ≥50% groups, the LGE extent was an independent predictor of adverse cardiac events. In conclusion, our qualitative and quantitative analyses of LGE-MRI provide long-term prognostic information after surgical revascularization. The LGE extent was a strong predictor of adverse cardiac events, independent of the LV function.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine, National Medical Centers, Seoul, Korea.
authors.forename: Seung-Ah
authors.initials: SA
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea. Electronic address: yeonyeeyoon@gmail.com.
authors.forename: Yeonyee E
authors.initials: YE
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jung-Eun
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jin Joo
authors.initials: JJ
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Il-Young
authors.initials: IY
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Chang-Hwan
authors.initials: CH
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Suh
authors.affiliation: Department of Thoracic Surgery, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jun-Sung
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Chun
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Young-Suk
authors.initials: YS
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Youn
authors.affiliation: Department of Thoracic Surgery, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Cheong
authors.initials: C
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Goo-Young
authors.initials: GY
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Chae
authors.affiliation: Department of Thoracic Surgery, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kay-Hyun
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Dong-Ju
authors.initials: DJ
authors.lastname: Choi
authors.affiliation: Department of Radiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Choi
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D057210:Delayed Diagnosis; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007275:Injections, Intravenous; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D057234:Preoperative Period; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis*
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA