title: Association Between Midwall Late Gadolinium Enhancement and Sudden Cardiac Death in Patients With Dilated Cardiomyopathy and Mild and Moderate Left Ventricular Systolic Dysfunction.
abstract: BACKGROUND
  Current guidelines only recommend the use of an implantable cardioverter defibrillator in patients with dilated cardiomyopathy for the primary prevention of sudden cardiac death (SCD) in those with a left ventricular ejection fraction (LVEF) <35%. However, registries of out-of-hospital cardiac arrests demonstrate that 70% to 80% of such patients have an LVEF >35%. Patients with an LVEF >35% also have low competing risks of death from nonsudden causes. Therefore, those at high risk of SCD may gain longevity from successful implantable cardioverter defibrillator therapy. We investigated whether late gadolinium enhancement (LGE) cardiovascular magnetic resonance identified patients with dilated cardiomyopathy without severe LV systolic dysfunction at high risk of SCD.
  
  
  METHODS
  We prospectively investigated the association between midwall LGE and the prespecified primary composite outcome of SCD or aborted SCD among consecutive referrals with dilated cardiomyopathy and an LVEF ≥40% to our center between January 2000 and December 2011 who did not have a preexisting indication for implantable cardioverter defibrillator implantation.
  
  
  RESULTS
  Of 399 patients (145 women, median age 50 years, median LVEF 50%, 25.3% with LGE) followed for a median of 4.6 years, 18 of 101 (17.8%) patients with LGE reached the prespecified end point, compared with 7 of 298 (2.3%) without (hazard ratio [HR], 9.2; 95% confidence interval [CI], 3.9-21.8;P<0.0001). Nine patients (8.9%) with LGE compared with 6 (2.0%) without (HR, 4.9; 95% CI, 1.8-13.5;P=0.002) died suddenly, whereas 10 patients (9.9%) with LGE compared with 1 patient (0.3%) without (HR, 34.8; 95% CI, 4.6-266.6;P<0.001) had aborted SCD. After adjustment, LGE predicted the composite end point (HR, 9.3; 95% CI, 3.9-22.3;P<0.0001), SCD (HR, 4.8; 95% CI, 1.7-13.8;P=0.003), and aborted SCD (HR, 35.9; 95% CI, 4.8-271.4;P<0.001). Estimated HRs for the primary end point for patients with an LGE extent of 0% to 2.5%, 2.5% to 5%, and >5% compared with those without LGE were 10.6 (95% CI, 3.9-29.4), 4.9 (95% CI, 1.3-18.9), and 11.8 (95% CI, 4.3-32.3), respectively.
  
  
  CONCLUSIONS
  Midwall LGE identifies a group of patients with dilated cardiomyopathy and an LVEF ≥40% at increased risk of SCD and low risk of nonsudden death who may benefit from implantable cardioverter defibrillator implantation.
  
  
  BACKGROUND
  URL: http://clinicaltrials.gov. Unique identifier: NCT00930735.
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Brian P
authors.initials: BP
authors.lastname: Halliday
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Ankur
authors.initials: A
authors.lastname: Gulati
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Aamir
authors.initials: A
authors.lastname: Ali
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Kaushik
authors.initials: K
authors.lastname: Guha
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Simon
authors.initials: S
authors.lastname: Newsome
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Monika
authors.initials: M
authors.lastname: Arzanauskaite
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Vassilios S
authors.initials: VS
authors.lastname: Vassiliou
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Amrit
authors.initials: A
authors.lastname: Lota
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Cemil
authors.initials: C
authors.lastname: Izgi
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Upasana
authors.initials: U
authors.lastname: Tayal
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Zohya
authors.initials: Z
authors.lastname: Khalique
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Colin
authors.initials: C
authors.lastname: Stirrat
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Dominique
authors.initials: D
authors.lastname: Auger
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Nilesh
authors.initials: N
authors.lastname: Pareek
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Tevfik F
authors.initials: TF
authors.lastname: Ismail
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Rosen
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Ali
authors.initials: A
authors.lastname: Vazir
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Francisco
authors.initials: F
authors.lastname: Alpendurada
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: John
authors.initials: J
authors.lastname: Gregson
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Michael P
authors.initials: MP
authors.lastname: Frenneaux
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Martin R
authors.initials: MR
authors.lastname: Cowie
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: John G F
authors.initials: JGF
authors.lastname: Cleland
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Cook
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.). dj.pennell@rbht.nhs.uk.
authors.forename: Dudley J
authors.initials: DJ
authors.lastname: Pennell
authors.affiliation: From National Institute for Health Research Cardiovascular Biomedical Research Unit and Cardiovascular Magnetic Resonance Unit (B.P.H., A.G., A.A., M.A., V.S.V., A.L. C.I., U.T. Z.K., D.A., F.A., J.G.F.C., S.A.C., D.J.P., S.K.P.), Department of Cardiology (K.G., N.P., S.D.R., A.V., M.R.C.), Royal Brompton Hospital, London, United Kingdom; National Heart and Lung Institute, Imperial College, London, United Kingdom (B.P.H., A.A., K.G., V.S.V., A.L., U.T., S.D.R., A.V., F.A., M.R.C., J.G.F.C., S.A.C., D.J.P., S.K.P.); London School of Hygiene and Tropical Medicine, United Kingdom (S.N., J.G.); Norwich Medical School, University of East Anglia, United Kingdom (V.S.V., M.P.F); Centre for Cardiovascular Science, University of Edinburgh, United Kingdom (C.S.); King's College London and Department of Cardiology, Guy's and St Thomas' Hospital, London, United Kingdom (T.F.I.); Department of Cardiology, Ealing Hospital, London, United Kingdom (S.D.R.); and National Heart Centre Singapore (S.A.C.).
authors.forename: Sanjay K
authors.initials: SK
authors.lastname: Prasad
mesh_terms: D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000473:pathology*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium / Q000008:administration & dosage; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000401:mortality*
chemical_list: D005682:Gadolinium
keywords: cardiovascular MRI; dilated cardiomyopathy; implantable cardioverter-defibrillator; late gadolinium enhancement; sudden cardiac death