1. Prognostic value of cardiovascular magnetic resonance T1 mapping techniques in non-ischemic dilated cardiomyopathy: A systematic review and meta-analysis
- Author
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Charalambos Karvounis, Apostolos Kiaos, Dimitra Antonakaki, Ornella Rimoldi, Maria-Anna Bazmpani, and Theodoros D. Karamitsos
- Subjects
Cardiomyopathy, Dilated ,medicine.medical_specialty ,Magnetic Resonance Spectroscopy ,Contrast Media ,Magnetic Resonance Imaging, Cine ,030204 cardiovascular system & hematology ,Cochrane Library ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,medicine.diagnostic_test ,business.industry ,Myocardium ,Hazard ratio ,Dilated cardiomyopathy ,Magnetic resonance imaging ,medicine.disease ,Prognosis ,Magnetic Resonance Imaging ,Confidence interval ,Cardiovascular magnetic resonance ,ECV ,Native T1 ,Non-ischemic dilated cardiomyopathy ,T1 mapping ,Meta-analysis ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Value (mathematics) ,Cohort study - Abstract
Background Cardiovascular magnetic resonance T1 mapping is a non-invasive tool for quantifying tissue alterations in the myocardium. Its prognostic value in non-ischemic dilated cardiomyopathy (DCM) remains unclear. The purpose of this study was to synthetize available data and explore the prognostic value of T1 mapping in DCM. Methods We searched Pubmed, Embase, Cochrane Library and Scopus for cohort studies up to 28 March 2020 that reported prognostic data for cardiovascular magnetic resonance T1 mapping in patients with DCM. Hazard ratios (HRs) were pooled using random-effects meta-analysis. Values were expressed as standard deviation (SD) of normal controls. Heterogeneity was assessed with the I2 statistic. Results Eight studies were included in the meta-analysis, with a total of 1242 patients. Extracellular volume fraction (ECV) had high prognostic value for a composite outcome of mortality and morbidity with HR 1.38 (95% confidence interval, 1.18–1.61). Native T1 was also shown to have high prognostic value for a composite outcome of mortality and morbidity with HR 1.20 (95% confidence interval, 1.14–1.27). Heterogeneity was moderate for the ECV analysis (I2 = 64%). Conclusions ECV and native T1 could potentially be used to improve risk stratification in DCM. Future studies should investigate the prognostic value of T1 mapping by separating mortality and morbidity as primary outcomes and evaluate its incremental value in addition to standard risk stratification criteria.
- Published
- 2020
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