Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults
AIMS: Non-ischaemic cardiomyopathies (NICM) can cause heart failure and death. Cardiac magnetic resonance (CMR) detects myocardial scar/fibrosis associated with myocardial infarction (MI) and NICM with late gadolinium enhancement (LGE). The aim of this study was to determine the prevalence and progn...
Published in: | European Heart Journal |
---|---|
Main Authors: | , , , , , , , , , , , , |
Format: | Text |
Language: | English |
Published: |
Oxford University Press
2019
|
Subjects: | |
Online Access: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6657269/ http://www.ncbi.nlm.nih.gov/pubmed/30445559 https://doi.org/10.1093/eurheartj/ehy713 |
id |
ftpubmed:oai:pubmedcentral.nih.gov:6657269 |
---|---|
record_format |
openpolar |
spelling |
ftpubmed:oai:pubmedcentral.nih.gov:6657269 2023-05-15T16:51:38+02:00 Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults Shanbhag, Sujata M Greve, Anders M Aspelund, Thor Schelbert, Erik B Cao, J Jane Danielsen, Ragnar þorgeirsson, Guðmundur Sigurðsson, Sigurður Eiríksdóttir, Guðný Harris, Tamara B Launer, Lenore J Guðnason, Vilmundur Arai, Andrew E 2019-02-07 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6657269/ http://www.ncbi.nlm.nih.gov/pubmed/30445559 https://doi.org/10.1093/eurheartj/ehy713 en eng Oxford University Press http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6657269/ http://www.ncbi.nlm.nih.gov/pubmed/30445559 http://dx.doi.org/10.1093/eurheartj/ehy713 Published by Oxford University Press on behalf of the European Society of Cardiology 2018. This work is written by US Government employees and is in the public domain in the US. PDM Clinical Research Text 2019 ftpubmed https://doi.org/10.1093/eurheartj/ehy713 2020-02-09T01:14:39Z AIMS: Non-ischaemic cardiomyopathies (NICM) can cause heart failure and death. Cardiac magnetic resonance (CMR) detects myocardial scar/fibrosis associated with myocardial infarction (MI) and NICM with late gadolinium enhancement (LGE). The aim of this study was to determine the prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in a community-based sample of older adults. METHODS AND RESULTS: The ICELAND-MI cohort, a substudy of the Age, Gene/Environment Susceptibility Reykjavik (AGES-Reykjavik) study, provided a well-characterized population of 900 subjects after excluding subjects with pre-existing heart failure. Late gadolinium enhancement CMR divided subjects into four groups: MI (n = 211), major (n = 54) non-ischaemic fibrosis (well-established, classic patterns, associated with myocarditis, infiltrative cardiomyopathies, or pathological hypertrophy), minor (n = 238) non-ischaemic fibrosis (remaining localized patterns not meeting major criteria), and a no LGE (n = 397) reference group. The primary outcome was time to death or first heart failure hospitalization. During a median follow-up of 5.8 years, 192 composite events occurred (115 deaths and 77 hospitalizations for incident heart failure). After inverse probability weighting, major non-ischaemic fibrosis [hazard ratio (HR) 3.2, P < 0.001] remained independently associated with the primary endpoint, while MI (HR 1.4, P = 0.10) and minor non-ischaemic LGE (HR 1.2, P = 0.39) did not. Major non-ischaemic fibrosis was associated with a poorer outcome than MI (HR = 2.3, P = 0.001) in the adjusted analysis. CONCLUSION: Major non-ischaemic patterns of myocardial fibrosis portended worse prognosis than no fibrosis/scar in an older community-based cohort. Traditional risk factors largely accounted for the effect of MI and minor non-ischaemic LGE. Text Iceland PubMed Central (PMC) European Heart Journal 40 6 529 538 |
institution |
Open Polar |
collection |
PubMed Central (PMC) |
op_collection_id |
ftpubmed |
language |
English |
topic |
Clinical Research |
spellingShingle |
Clinical Research Shanbhag, Sujata M Greve, Anders M Aspelund, Thor Schelbert, Erik B Cao, J Jane Danielsen, Ragnar þorgeirsson, Guðmundur Sigurðsson, Sigurður Eiríksdóttir, Guðný Harris, Tamara B Launer, Lenore J Guðnason, Vilmundur Arai, Andrew E Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults |
topic_facet |
Clinical Research |
description |
AIMS: Non-ischaemic cardiomyopathies (NICM) can cause heart failure and death. Cardiac magnetic resonance (CMR) detects myocardial scar/fibrosis associated with myocardial infarction (MI) and NICM with late gadolinium enhancement (LGE). The aim of this study was to determine the prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in a community-based sample of older adults. METHODS AND RESULTS: The ICELAND-MI cohort, a substudy of the Age, Gene/Environment Susceptibility Reykjavik (AGES-Reykjavik) study, provided a well-characterized population of 900 subjects after excluding subjects with pre-existing heart failure. Late gadolinium enhancement CMR divided subjects into four groups: MI (n = 211), major (n = 54) non-ischaemic fibrosis (well-established, classic patterns, associated with myocarditis, infiltrative cardiomyopathies, or pathological hypertrophy), minor (n = 238) non-ischaemic fibrosis (remaining localized patterns not meeting major criteria), and a no LGE (n = 397) reference group. The primary outcome was time to death or first heart failure hospitalization. During a median follow-up of 5.8 years, 192 composite events occurred (115 deaths and 77 hospitalizations for incident heart failure). After inverse probability weighting, major non-ischaemic fibrosis [hazard ratio (HR) 3.2, P < 0.001] remained independently associated with the primary endpoint, while MI (HR 1.4, P = 0.10) and minor non-ischaemic LGE (HR 1.2, P = 0.39) did not. Major non-ischaemic fibrosis was associated with a poorer outcome than MI (HR = 2.3, P = 0.001) in the adjusted analysis. CONCLUSION: Major non-ischaemic patterns of myocardial fibrosis portended worse prognosis than no fibrosis/scar in an older community-based cohort. Traditional risk factors largely accounted for the effect of MI and minor non-ischaemic LGE. |
format |
Text |
author |
Shanbhag, Sujata M Greve, Anders M Aspelund, Thor Schelbert, Erik B Cao, J Jane Danielsen, Ragnar þorgeirsson, Guðmundur Sigurðsson, Sigurður Eiríksdóttir, Guðný Harris, Tamara B Launer, Lenore J Guðnason, Vilmundur Arai, Andrew E |
author_facet |
Shanbhag, Sujata M Greve, Anders M Aspelund, Thor Schelbert, Erik B Cao, J Jane Danielsen, Ragnar þorgeirsson, Guðmundur Sigurðsson, Sigurður Eiríksdóttir, Guðný Harris, Tamara B Launer, Lenore J Guðnason, Vilmundur Arai, Andrew E |
author_sort |
Shanbhag, Sujata M |
title |
Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults |
title_short |
Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults |
title_full |
Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults |
title_fullStr |
Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults |
title_full_unstemmed |
Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults |
title_sort |
prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults |
publisher |
Oxford University Press |
publishDate |
2019 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6657269/ http://www.ncbi.nlm.nih.gov/pubmed/30445559 https://doi.org/10.1093/eurheartj/ehy713 |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6657269/ http://www.ncbi.nlm.nih.gov/pubmed/30445559 http://dx.doi.org/10.1093/eurheartj/ehy713 |
op_rights |
Published by Oxford University Press on behalf of the European Society of Cardiology 2018. This work is written by US Government employees and is in the public domain in the US. |
op_rightsnorm |
PDM |
op_doi |
https://doi.org/10.1093/eurheartj/ehy713 |
container_title |
European Heart Journal |
container_volume |
40 |
container_issue |
6 |
container_start_page |
529 |
op_container_end_page |
538 |
_version_ |
1766041740457803776 |