ArticlePloS one2023
Risk stratification in patients with structurally normal hearts: Does fibrosis type matter?
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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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.
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.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Prediction of ventricular arrhythmias and sudden cardiac death by quantification and location of late gadolinium enhancement on cardiac magnetic resonance: a systematic review and meta-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Pooled it
- Exploring sex differences in myocardial fibrosis in patients with structurally normal hearts.Scientific reports · 2025Article
- Computed Tomography-Derived Extracellular Volume Fraction in Non-ST-Segment Elevation Myocardial Infarction With Multivessel Disease.JACC. Case reports · 2025Article
- Serial Assessment of Extracellular Volume Fraction Derived on Coronary Computed Tomography Angiography in Takotsubo Cardiomyopathy.JACC. Case reports · 2025Article
- Shaping cardiac diagnostics: The role of myocardial tissue mapping in unraveling ring-like fibrosis.Cardiology journal · 2025Article
- Breaking new ground in heart failure management: novel therapies and future frontiers.Frontiers in cardiovascular medicine · 2025Review
- Left Ventricular Hypertrabeculation (LVHT) in Athletes: A Negligible Finding?Medicina (Kaunas, Lithuania) · 2024Article
- Serial Extracellular Volume by Coronary Computed Tomography After Acute Myocardial Infarction With Left-Main Vasospasm.Circulation reports · 2024Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
objectivesThe study sought to assess the prognostic significance of nonischemic myocardial fibrosis (MF) on cardiovascular magnetic resonance (CMR)-both macroscopic MF assessed by late gadolinium enhancement (LGE) and diffuse microscopic MF quantified by extracellular volume fraction (ECV)-in patients with structurally normal hearts.
backgroundThe clinical relevance of tissue abnormalities identified by CMR in patients with structurally normal hearts remains unclear.
methodsConsecutive patients undergoing CMR were screened for inclusion to identify those with LGE imaging and structurally normal hearts. ECV was calculated in patients with available T1 mapping. The associations between myocardial fibrosis and the outcomes of all-cause mortality, new-onset heart failure [HF], and an arrhythmic outcome were evaluated.
resultsIn total 525 patients (mean age 43.1±14.2 years; 30.5% males) were included. Over a median follow-up of 5.8 years, 13 (2.5%) patients died and 18 (3.4%) developed new-onset HF. Nonischemic midwall /subepicardial LGE was present in 278 (52.9%) patients; isolated RV insertion fibrosis was present in 80 (15.2%) patients. In 276 patients with available T1 mapping, the mean ECV was 25.5 ± 4.4%. There was no significant association between LGE and all-cause mortality (HR: 1.36, CI: 0.42-4.42, p = 0.61), or new-onset HF (HR: 0.64, CI: 0.25-1.61, p = 0.34). ECV (per 1% increase) correlated with all-cause mortality (HR: 1.19, CI: 1.04-1.36, p = 0.009), but not with new-onset HF (HR: 0.97, CI: 0.86-1.10, p = 0.66). There was no significant association between arrhythmic outcomes and LGE (p = 0.60) or ECV (p = 0.49). In a multivariable model after adjusting for covariates, ECV remained significantly associated with all-cause mortality (HR per 1% increase in ECV: 1.26, CI: 1.06-1.50, p = 0.009).
conclusionNonischemic LGE in patients with structurally normal hearts is common and does not appear to be associated with adverse outcomes, whereas elevated ECV is associated with all-cause mortality and may be an important risk stratification tool.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.