Featured Research

from universities, journals, and other organizations

Scarring of heart muscle linked with increased risk of death in patients with type of cardiomyopathy

Date:
March 5, 2013
Source:
American Medical Association (AMA)
Summary:
Detection of midwall fibrosis (the presence of scar tissue in the middle of the heart muscle wall) via magnetic resonance imaging among patients with nonischemic dilated cardiomyopathy (a condition affecting the heart muscle) was associated with an increased likelihood of death, according to a new study.

Detection of midwall fibrosis (the presence of scar tissue in the middle of the heart muscle wall) via magnetic resonance imaging among patients with nonischemic dilated cardiomyopathy (a condition affecting the heart muscle) was associated with an increased likelihood of death, according to a study appearing in the March 6 issue of JAMA.

Nonischemic dilated cardiomyopathy is associated with significant illness and death due to progressive heart failure (HF) and sudden cardiac death (SCD). Despite therapeutic advances, 5-year mortality remains as high as 20 percent. "Risk stratification of patients with nonischemic dilated cardiomyopathy is primarily based on left ventricular ejection fraction [LVEF; a measure of how well the left ventricle of the heart pumps with each contraction]. Superior prognostic factors may improve patient selection for implantable cardioverter-defibrillators (ICDs) and other management decisions," according to background information in the article. Attention has recently focused on whether detection of myocardial replacement fibrosis (scarring of the heart muscle) may assist with risk stratification in dilated cardiomyopathy. Fibrosis is associated with contractile impairment.

Ankur Gulati, M.D., of Royal Brompton Hospital, London, and colleagues evaluated whether midwall fibrosis (detected by late gadolinium enhancement cardiovascular magnetic resonance [LGE-CMR] imaging) predicts risk of death, independently of LVEF and other established prognostic factors in dilated cardiomyopathy. The study included 472 patients with dilated cardiomyopathy referred to a U.K. center for CMR imaging between November 2000 and December 2008 after presence and extent of midwall replacement fibrosis (scarring of the heart muscle present in the middle of the heart muscle wall) were determined. Patients were followed up through December 2011.

During a median (midpoint) follow-up of 5.3 years, there were 73 deaths. Overall, 38 of 142 patients with midwall fibrosis (26.8 percent) died compared with 35 of 330 patients without midwall fibrosis (10.6 percent). After analysis, both the presence and percentage extent of midwall fibrosis were significant independent predictors of all-cause mortality. The arrhythmic composite end point (SCD or aborted SCD) occurred in 65 patients (14 percent). Analysis indicated that patients with midwall fibrosis were more than 5 times more likely to experience SCD or aborted SCD compared with patients without midwall fibrosis (29.6 percent vs. 7.0 percent).

"After adjustment for LVEF and other conventional prognostic factors, both the presence of fibrosis and the extent were independently and incrementally associated with all-cause mortality. Fibrosis was also independently associated with cardiovascular mortality or cardiac transplantation, SCD or aborted SCD, and the HF composite [HF death, HF hospitalization, or cardiac transplantation]," the authors write.

Also, the addition of fibrosis to LVEF significantly improved risk reclassification for all-cause mortality and the SCD composite.

"Our findings suggest that detection and quantification of midwall fibrosis by LGE-CMR may represent useful markers for the risk stratification of death, ventricular arrhythmia, and HF for patients with dilated cardiomyopathy," the researchers write.


Story Source:

The above story is based on materials provided by American Medical Association (AMA). Note: Materials may be edited for content and length.


Journal Reference:

  1. Ankur Gulati et al. Association of Fibrosis With Mortality and Sudden Cardiac Death in Patients With Nonischemic Dilated Cardiomyopathy. JAMA, 2013 DOI: 10.1001/jama.2013.1363

Cite This Page:

American Medical Association (AMA). "Scarring of heart muscle linked with increased risk of death in patients with type of cardiomyopathy." ScienceDaily. ScienceDaily, 5 March 2013. <www.sciencedaily.com/releases/2013/03/130305174048.htm>.
American Medical Association (AMA). (2013, March 5). Scarring of heart muscle linked with increased risk of death in patients with type of cardiomyopathy. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2013/03/130305174048.htm
American Medical Association (AMA). "Scarring of heart muscle linked with increased risk of death in patients with type of cardiomyopathy." ScienceDaily. www.sciencedaily.com/releases/2013/03/130305174048.htm (accessed July 31, 2014).

Share This




More Health & Medicine News

Thursday, July 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Concern Grows Over Worsening Ebola Crisis

Concern Grows Over Worsening Ebola Crisis

AFP (July 30, 2014) Pan-African airline ASKY has suspended all flights to and from the capitals of Liberia and Sierra Leone amid the worsening Ebola health crisis, which has so far caused 672 deaths in Guinea, Liberia and Sierra Leone. Duration: 00:43 Video provided by AFP
Powered by NewsLook.com
At Least 20 Chikungunya Cases in New Jersey

At Least 20 Chikungunya Cases in New Jersey

AP (July 30, 2014) At least 20 New Jersey residents have tested positive for chikungunya, a mosquito-borne virus that has spread through the Caribbean. (July 30) Video provided by AP
Powered by NewsLook.com
Xtreme Eating: Your Daily Caloric Intake All On One Plate

Xtreme Eating: Your Daily Caloric Intake All On One Plate

Newsy (July 30, 2014) The Center for Science in the Public Interest released its 2014 list of single meals with whopping calorie counts. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



    Save/Print:
    Share:

    Free Subscriptions


    Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

    Get Social & Mobile


    Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

    Have Feedback?


    Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
    Mobile: iPhone Android Web
    Follow: Facebook Twitter Google+
    Subscribe: RSS Feeds Email Newsletters
    Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins