Late Gadolinium Enhancement on Cardiac MRI and the Prognosis of Patients With Pulmonary Hypertension: A Meta-Analysis

IF 1.4 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2025-08-28 DOI:10.1111/echo.70278

Wenjuan Han, Qijun Ban, Deyin Zhai, Yujie Zhai

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引用次数: 0

Abstract

Purpose

Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (MRI) is indicative of myocardial fibrosis and has been proposed as a prognostic marker in patients with pulmonary hypertension (PH). However, the strength and consistency of this association remain uncertain. This meta-analysis aims to evaluate the relationship between LGE and adverse clinical outcomes in patients with PH.

Methods

PubMed, Embase, and Web of Science were systematically searched from the inception of each database through March 28, 2025, for longitudinal observational studies reporting on the prognostic value of LGE detected by cardiac MRI in PH. Risk ratios (RRs) and 95% confidence intervals (CIs) were pooled using a random-effects model to account for between-study heterogeneity.

Results

Ten studies involving 733 patients were included. The presence of LGE on cardiac MRI was associated with a nonsignificant trend toward increased risk of adverse clinical outcomes (RR = 1.23, 95% CI: 0.99–1.54; p = 0.07; I² = 40%). A similar result was observed in the sensitivity analysis restricted to high-quality studies (RR = 1.15, 95% CI: 0.98–1.36; p = 0.10; I² = 14%). Subgroup analyses showed consistent trends across all stratifications, with no significant differences (all p > 0.05). No evidence of publication bias was detected.

Conclusion

LGE on cardiac MRI may be associated with adverse outcomes in patients with PH; however, the current evidence remains inconclusive. Further large-scale, prospective studies are warranted to clarify its prognostic value.

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心脏MRI晚期钆增强与肺动脉高压患者预后的meta分析

目的心脏磁共振成像（MRI）晚期钆增强（LGE）是心肌纤维化的指示性指标，已被提出作为肺动脉高压（PH）患者的预后指标。然而，这种联系的强度和一致性仍然不确定。本荟萃分析旨在评估LGE与ph患者不良临床结局之间的关系。方法系统检索PubMed、Embase和Web of Science，从每个数据库建立之初到2025年3月28日。对于纵向观察性研究，报告了心脏MRI在ph中检测到LGE的预后价值。使用随机效应模型合并风险比（rr）和95%置信区间（CIs），以解释研究间的异质性。结果纳入10项研究，733例患者。心脏MRI上LGE的存在与不良临床结果风险增加的无显著趋势相关（RR = 1.23, 95% CI: 0.99-1.54; p = 0.07; I2 = 40%）。在仅限于高质量研究的敏感性分析中也观察到类似的结果（RR = 1.15, 95% CI: 0.98-1.36; p = 0.10; I2 = 14%）。亚组分析显示所有分层的趋势一致，无显著差异（均p >； 0.05）。未发现发表偏倚的证据。结论心脏MRI LGE可能与PH患者不良预后相关；然而，目前的证据仍然不确定。需要进一步的大规模前瞻性研究来阐明其预后价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.