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June 26, 2013

Fibrosis and Mortality in Patients With Dilated Cardiomyopathy

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Scuola Superiore Sant’Anna, Pisa, Italy (Dr Barison; barison@sssup.it); and Fondazione “G.Monasterio” CNR—Regione Toscana, Pisa, Italy (Drs Masci and Emdin).

JAMA. 2013;309(24):2547. doi:10.1001/jama.2013.6453

To the Editor: Dr Gulati and colleagues1 demonstrated that midwall fibrosis assessed by late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR) imaging provided independent prognostic information in a single-center, prospective longitudinal study of 472 patients with dilated cardiomyopathy followed up for a median of 5.3 years.

Both presence and extent of fibrosis were associated with major adverse outcomes (all-cause mortality, cardiovascular mortality, heart failure, and malignant arrhythmias) after adjustment for left ventricular ejection fraction and clinical data (conventional risk factors, New York Heart Association class, arterial blood pressure, left bundle branch block, previous arrhythmias).