Teraoka Yuri, Kato Shingo, Yasuda Naofumi, Sawamura Shungo, Horita Nobuyuki, Utsunomiya Daisuke
Department of Diagnostic Radiology, Graduate School of Medicine, Yokohama City University, Kanagawa 236-00204, Japan.
Chemotherapy Center, Yokohama City University Hospital, Kanagawa 236-0004, Japan.
J Clin Med. 2025 Jan 29;14(3):895. doi: 10.3390/jcm14030895.
: Late gadolinium enhancement (LGE)-MRI has proven utility in prognosticating outcomes in patients with non-ischemic cardiomyopathy (NICM). However, evidence regarding its ability to predict responsiveness to optimal medical therapy remains insufficient. This study conducted a meta-analysis to evaluate the predictive utility of LGE-MRI for left ventricular reverse remodeling (LVRR) in response to pharmacological therapy. : Data from 1092 NICM patients across 13 studies were included in the analysis. To assess the predictive ability of LGE-MRI for LVRR following optimal medical therapy, a pooled odds ratio was calculated using an inverse variance random-effects meta-analysis. Subgroup analyses were performed by stratifying patients based on the presence or absence of left ventricular dilation and by LVEF (<30% vs. ≥30%). : The pooled odds ratio of the absence of LGE for predicting LVRR in NICM was 3.72 (95% CI: 2.83-4.90, I = 0, P for heterogeneity = 0.54). A comparison of pooled odds ratios between dilated cardiomyopathy (DCM) and NICM showed no significant difference ( = 0.16). A subgroup analysis in NICM based on the left ventricular ejection fraction (LVEF) demonstrated no significant difference in odds ratios between patients with LVEF <30% (OR: 2.96, 95% CI: 1.80-4.87) and those with LVEF ≥30% (OR: 3.97, 95% CI: 2.97-5.31), ( = 0.13). : This meta-analysis suggested that LGE-MRI serves as a reliable predictor of LVRR in patients with NICM, regardless of left ventricular dilation or baseline LVEF classification.
延迟钆增强（LGE）磁共振成像（MRI）已被证明在预测非缺血性心肌病（NICM）患者的预后方面具有实用价值。然而，关于其预测对最佳药物治疗反应性的能力的证据仍然不足。本研究进行了一项荟萃分析，以评估LGE-MRI对药物治疗反应的左心室逆向重构（LVRR）的预测效用。：分析纳入了来自13项研究的1092例NICM患者的数据。为了评估LGE-MRI对最佳药物治疗后LVRR的预测能力，使用逆方差随机效应荟萃分析计算合并优势比。根据左心室扩张的有无以及左心室射血分数（LVEF）（<30%与≥30%）对患者进行分层，进行亚组分析。：NICM中无LGE预测LVRR的合并优势比为3.72（95%CI：2.83-4.90，I²=0，异质性P=0.54）。扩张型心肌病（DCM）和NICM之间的合并优势比比较无显著差异（P=0.16）。基于左心室射血分数（LVEF）在NICM中的亚组分析表明，LVEF<30%的患者（OR：2.96，95%CI：1.80-4.87）和LVEF≥30%的患者（OR：3.97，95%CI：2.97-5.31）之间的优势比无显著差异（P=0.13）。：这项荟萃分析表明，无论左心室扩张或基线LVEF分类如何，LGE-MRI都是NICM患者LVRR的可靠预测指标。
