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Magnetic resonance imaging (MRI) can be used to assess fibrosis in vivo by demonstrating late gadolinium enhancement (LGE) in the myocardium. But can LGE help determine who is at risk for mortality and arrhythmic events? In this single-center, longitudinal analysis, 472 patients with nonischemic dilated cardiomyopathy underwent cardiovascular MRI with LGE assessment.
During a median follow-up of more than 5 years, mortality was 26.8% in patients with LGE suggesting midwall replacement fibrosis and 10.6% in those without LGE (hazard ratio, 2.96; P<0.001). Sudden cardiac death (SCD) or aborted SCD was also significantly more common in patients with midwall fibrosis (29.6% vs. 7%). Even after adjustment for ejection fraction and other known pro…