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Heart failure and cardiomyopathies
Original research article
MRI and serum high-sensitivity C reactive protein predict long-term mortality in non-ischaemic cardiomyopathy
  1. Taketaro Sadahiro1,
  2. Shun Kohsaka1,
  3. Shigeo Okuda2,
  4. Taku Inohara1,
  5. Yasuyuki Shiraishi1,
  6. Takashi Kohno1,
  7. Tsutomu Yoshikawa3 and
  8. Keiichi Fukuda1
  1. 1Department of Cardiology, Keio University School of Medicine, Tokyo, Shinjuku-ku, Japan
  2. 2Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Shinjuku-ku, Japan
  3. 3Sakakibara Heart Institute, Tokyo, Japan
  1. Correspondence to Dr Shun Kohsaka; kohsaka{at}cpnet.med.keio.ac.jp

Abstract

Objective Myocardial fibrosis related to non-specific inflammation can be detected using late gadolinium-enhancement cardiovascular MR (LGE-CMR), which is an important prognostic indicator for dilated cardiomyopathy (DCM). The aims of this study were to define the prognostic factors for DCM with LGE-CMR, and to evaluate the impact of the prognostic factors on adverse effects.

Methods We performed a retrospective analysis of a prospectively maintained single centre registry. We analysed the data from 76 patients with DCM who had been admitted for acute heart failure. The primary combined end point was defined as all-cause mortality and rehospitalisation.

Results LGE-CMR was present in 39 patients (51%), and the mean follow-up period was 813±54 days. The primary end point occurred in 20 patients (5 (13.5%) patients without LGE-CMR and 15 (38.5%) patients with LGE-CMR, p=0.006). Sixteen of 39 patients with LGE-CMR exhibited elevated high-sensitivity C reactive protein (hs-CRP >0.3 mg/dL). Patients with elevated hs-CRP and LGE-CMR had a significantly higher incidence of the primary end point compared with patients with normal hs-CRP and LGE-CMR (62.5%; 10 patients, 22.7%; 5 patients, respectively, p=0.001). Elevated hs-CRP was significantly associated with the primary end point (HR: 4.04; 95% CI 1.67 to 9.76; p=0.002). After elevated hs-CRP was adjusted for known predictors of DCM, it was still associated with the primary end point (HR: 2.91; 95% CI 1.19 to 7.15; p=0.02).

Conclusions Among patients with DCM, LGE-CMR and elevated hs-CRP are associated with a higher incidence of the long-term combined end point of all-cause mortality and hospitalisation.

Trial registration number: UMIN000001171.

  • HEART FAILURE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/openhrt-2015-000298

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