1002 Women with severe ischemic cardiomyopathy have worse survival than men despite similar degree of myocardial scar: a delayed hyper-enhancement MRI study

Abstract

Methods 349 patients (24% women) with severe ICM >/= 70% stenosis in >/= 1 epicardial vessel on angiography and mean LV ejection fraction (EF) 23%], that underwent DHE-MRI (Siemens 1.5 T scanner, Erlangen, Germany) from 2003– 6 were studied. DHE-MR images were obtained in standard long and short axis orientations (covering the entire LV), after injection of Gadolinium dimenglumine using an inversion recovery spoiled gradient echo sequence: TE 4 msec, TR 8 msec, flip angle 300, bandwidth 140 Hz/ pixel, 23 k-space lines acquired every other RR-interval, field of view (varied from 228–330 in the x-direction and 260–330 in the y-direction) and matrix size (varied from 140–180 in the x-direction and 256 in the y-direction). For DHE-MRI analysis, a custom analysis package (VPT software, Siemens, Erlangen, Germany) was used to manually delineate endocardial and epicardial myocardial edges. Scar was defined (as % of myocardium in a 17-segment model on custom software, Siemens Research) on DHE-MR images, as intensity > 2 standard deviation above viable myocardium. Transmurality score was recorded in all segments as follows: 0 = no scar, 1 = 1– 25% scar, 2 = 26–50%, 3 = 51–75% and 4 = > 75%. Global LV scar burden was calculated as transmurality score for all segments/17. LV volumes, EF, demographic/clinical data, history of cardiac transplantation and all-cause mortality were recorded.