Prevalence of Myocardial Fibrosis Patterns in Patients With Systolic Dysfunction Prognostic Significance for the Prediction of Sudden Cardiac Arrest or Appropriate Implantable Cardiac Defibrillator Therapy

Background—Late gadolinium enhancement-cardiac magnetic resonance is increasingly performed in patients with systolic dysfunction. Numerous patterns of fibrosis are commonly reported among this population. However, the relative prevalence and prognostic significance of these findings remains uncertain. Methods and Results—Three hundred eighteen consecutive patients referred for late gadolinium enhancement-cardiac magnetic resonance and a left ventricular ejection fraction 35% (40% versus 6%; P=0.005). Conclusions—Patients with systolic dysfunction frequently demonstrate multiple patterns of myocardial fibrosis. Of these, a midwall striae pattern of fibrosis is the strongest independent predictor of sudden cardiac arrest or appropriate implantable cardiac defibrillator therapy. ( Circ Cardiovasc Imaging. 2014;7:593-600.)