Novel Prognostic Markers Derived from Cardiovascular Magnetic Resonance Imaging in Patients with Stable Chronic Coronary Artery Disease.

BACKGROUND In patients with coronary artery disease (CAD), risk stratification remains a challenge. Recently, epicardial adipose tissue (EAT) assessed by cardiovascular magnetic resonance imaging (CMRI) has emerged as a new marker in patients with CAD. Thus, we aimed to investigate the association of CMR parameters with all-cause and cardiac mortality in patients with CAD. PATIENTS AND METHODS CMRI examination was performed in 260 patients with CAD. RESULTS In the 40 patients who died, left ventricular (LV) ejection fraction, right ventricular fractioning shortening, LV remodeling index and indexed EAT were significantly reduced, whereas LV mass index, LV end-diastolic volume index, LV end-systolic volume index, LV end-diastolic diameter and the extent of late gadolinium enhancement expressed as a percentage of the maximum possible score to estimate the extent of LGE relative to LV mass (LGE %), were significantly elevated. Using multivariate analysis, age, LV mass index, extent of LGE % and indexed EAT proved to be independently associated with all-cause and cardiac mortality. CONCLUSION Age, LV mass index, the extent of LGE % and indexed EAT are independent predictors of mortality that might contribute to a more accurate risk stratification of patients with CAD.