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Prognostic value of late gadolinium enhancement in hypertensive patients with known or suspected coronary artery disease

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Abstract

To determine the prognosis of a myocardial scar assessed by a late gadolinium enhancement (LGE) technique of cardiac magnetic resonance (CMR) in hypertensive patients with known or suspected coronary artery disease (CAD). Patients with systemic hypertension with known or suspected CAD without a clinical history of myocardial infarction were enrolled. All patients underwent CMR for assessment of cardiac function and LGE. Prognostic data was determined by the occurrence of a hard cardiac endpoint, defined as cardiac death or a non-fatal myocardial infarction, or major adverse cardiac events (MACEs), defined as cardiac death, a non-fatal myocardial infarction, or hospitalization due to heart failure, unstable angina, or life-threatening ventricular arrhythmia. A total of 1,644 patients were enrolled; 48% were males and the mean age was 65 ± 11 years. The average follow-up time was 863 ± 559 days. Four hundred fifty-three (28%) patients had LGE. LGE was the strongest and most independent predictor for hard events and MACEs with hazard ratios of 4.77 and 3.38, respectively. Other independent predictors of hard events and MACEs were left ventricular ejection fraction and mass, the use of a beta-blocker, and a history of heart failure. The risk of cardiac events increased as the extent of LGE increased; the hazard ratio was 12.74 for hard events for those with a LGE >20% of the myocardium. LGE is the most important and independent predictor for cardiac events in hypertensive patients with known or suspected CAD.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand

    Rungroj Krittayaphong, Thananya Boonyasirinant & Adisak Maneesai

  2. Her Majesty Cardiac Center, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand

    Vithaya Chaithiraphan, Supaporn Nakyen, Prajak Thanapiboonpol & Ahthit Yindeengam

  3. Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand

    Pairash Saiviroonporn

  4. Department of Research Promotion, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand

    Suthipol Udompanturak

Authors
  1. Rungroj Krittayaphong
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  2. Thananya Boonyasirinant
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  3. Vithaya Chaithiraphan
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  4. Adisak Maneesai
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  5. Pairash Saiviroonporn
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  6. Supaporn Nakyen
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  7. Prajak Thanapiboonpol
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  9. Suthipol Udompanturak
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Correspondence to Rungroj Krittayaphong.

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Krittayaphong, R., Boonyasirinant, T., Chaithiraphan, V. et al. Prognostic value of late gadolinium enhancement in hypertensive patients with known or suspected coronary artery disease. Int J Cardiovasc Imaging 26 (Suppl 1), 123–131 (2010). https://doi.org/10.1007/s10554-009-9574-7

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  • DOI: https://doi.org/10.1007/s10554-009-9574-7

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