Evidence map›Paper›PMID 31838882›Full record

ArticleCirculation. Cardiovascular imaging2019

Myocardial Extracellular Volume Fraction Adds Prognostic Information Beyond Myocardial Replacement Fibrosis.

Eric Y Yang, Mohamad G Ghosn, Mohammad A Khan, Nickalaus L Gramze, Gerd Brunner, Faisal Nabi, Vijay Nambi, Sherif F Nagueh, Duc T Nguyen, Edward A Graviss and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular imaging, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
66citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

66 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  4. Next-generation molecular imaging of cardiac fibrosis.The international journal of cardiovascular imaging · 2026
    Review
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6 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Eric Y YangHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
Mohamad G GhosnHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
Mohammad A KhanHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
Nickalaus L GramzeHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
Gerd BrunnerHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
Faisal NabiHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
Vijay NambiHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
Sherif F NaguehHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
Duc T NguyenHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
Edward A GravissHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
Erik B SchelbertDepartment of Medicine, University of Pittsburgh School of Medicine, PA (E.B.S.).
Christie M BallantyneHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
William A ZoghbiHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).
Dipan J ShahHouston Methodist Hospital, Houston, TX (E.Y.Y., M.G.G., M.A.K., N.L.G., G.B., F.N., V.N., S.F.N., D.T.N., E.A.G., C.M.B., W.A.Z., D.J.S.).

Funding

Magnetic Resonance Imaging Based Calf Muscle Perfusion To Assess Patients With Symptomatic Peripheral Artery DiseaseR01HL137763 · NHLBI · PENNSYLVANIA STATE UNIV HERSHEY MED CTR · PI BRUNNER, GERD · 2017 to 2021
$2.6M
Microvascular Perfusion Assessment of Ischemic Diabetic Ulcers Using MRIK25HL121149 · NHLBI · PENNSYLVANIA STATE UNIV HERSHEY MED CTR · PI BRUNNER, GERD · 2015 to 2019
$799k
National Science Foundation 1646586NHLBI NIH HHS 1R01HL137763-01NHLBI NIH HHS K25 HL121149NHLBI NIH HHS R01 HL137763
6 · The paper itself

Abstract

backgroundCardiac magnetic resonance techniques permit quantification of the myocardial extracellular volume fraction (ECV), representing a surrogate marker of reactive interstitial fibrosis, and late gadolinium enhancement (LGE), representing replacement fibrosis or scar. ECV and LGE have been independently linked with heart failure (HF) events. In deriving ECV, coronary artery disease type LGE, but not non-coronary artery disease type LGE, has been consistently excluded. We examined the associations between LGE, global ECV derived from myocardial tissue segments free of any detectable scar, and subsequent HF events.

methodsMid short-axis T1 maps were divided into 6 cardiac segments, each classified as LGE absent or present. Global ECV was derived from only segments without LGE. ECV was considered elevated if >30%, the upper 95% bounds of a reference group without known cardiac disease (n=28). Patients were divided into 4 groups by presence of elevated ECV and of any LGE. Subsequent HF hospitalization and any death were ascertained. Their relationship with ECV was examined separately and as a composite with Cox proportional hazard models.

resultsOf 1604 serial patients with T1 maps, 1255 were eligible after exclusions and followed over a median 26.3 (interquartile range, 15.9-37.5) months. Patients with elevated ECV had increased risk for death (hazard ratio [HR] 2.45 [95% CI, 1.76-3.41]), HF hospitalization (HR, 2.45 [95% CI, 1.77-3.40]), and a combined end point of both outcomes (HR, 2.46 [95% CI, 1.94-3.14]). After adjustments for covariates including LGE, the relationship persisted for death (HR, 1.82 [95% CI, 1.28-2.59]), hospitalization (HR, 1.60 [95% CI, 1.12-2.27]), and combined end points (HR, 1.73 [95% CI, 1.34-2.24]).

conclusionsECV measures of diffuse myocardial fibrosis were associated with HF outcomes, despite exclusion of replacement fibrosis segments from their derivation and even among patients without any scar. ECV may have a synergistic role with LGE in HF risk assessment.

Indexed as

AdultAgedCardiomyopathiesContrast MediaExtracellular SpaceFemaleFibrosisFollow-Up StudiesGadolinium DTPAHumansMagnetic Resonance Imaging, CineMaleMiddle AgedMyocardiumPrognosisProspective StudiesContrast MediaGadolinium DTPAepidemiologyextracellular matrixextracellular spacefibrosisgadoliniummagnetic resonance imagingmyocardium

Identifiers

PMID31838882
PMCPMC7529265

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