Long-term prognostic value of XXXX stress CMR.

@entity1 @entity452 @entity583 @entity854 @entity299 @entity453 @entity204
OBJECTIVES: The aim of this study was to assess the long-term value of high-dose @entity452 cardiac magnetic resonance (DCMR) for the prediction of @entity299 in a large cohort of @entity1 with known or suspected @entity453 . BACKGROUND: High-dose DCMR has been shown to be a useful technique for diagnosis and intermediate-term prognostic stratification. METHODS: Clinical data and DCMR results were analyzed in 1,463 consecutive @entity1 undergoing DCMR between 2000 and 2004. Ninety-four @entity1 were lost to follow-up. The remaining 1,369 @entity1 were followed up for a mean of 44    24 months. @entity299 , defined as @entity204 and nonfatal @entity583 , were related to clinical and DCMR results. RESULTS: Three-hundred fifty-two @entity1 underwent early revascularization (<= 3 months of DCMR) and were excluded from analysis. Of the remaining 1,017 @entity1 , 301 @entity1 (29.6%) experienced inducible @entity854 ( @entity854 ). Forty-six @entity299 were reported. In those with and without inducible @entity854 , the proportion of @entity1 with @entity299 was 8.0% versus 3.1%, respectively, p = 0.001 (hazard ratio: 3.3; 95% confidence interval: 1.8 to 5.9 for the presence of inducible @entity854 ; p < 0.001). A DCMR without inducible @entity854 carried an excellent prognosis, with a 6-year cardiac event-free survival of 96.8%. In all 1,369 @entity1 in the @entity1 group with stress-inducible @entity854 , those @entity1 with medical therapy demonstrated a trend to a higher cardiac event rate (8.0%) than those with early revascularization (5.4%) (p = 0.234). @entity1 with normal DCMR and medical therapy or early revascularization demonstrated similar cumulative cardiac event rates (3.1% vs. 3.2%, p = 0.964). CONCLUSIONS: In a large cohort of @entity1 , DCMR has an added value for predicting @entity299 during long-term follow-up, improving the differentiation between high-risk and low-risk @entity1 . @entity1 with inducible @entity854 and following early revascularization, demonstrate lower cardiac event rates than @entity1 with medical therapy alone.
