{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T01:14:24Z","timestamp":1772500464104,"version":"3.50.1"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Infarct heterogeneity has been shown to be independently associated with adverse outcomes in previous smaller studies. However, it is unknown whether infarct characterization is an independent predictor of all-cause mortality in patients with advanced ischemic cardiomyopathy, after adjusting for clinical risk factors, severity of ischemic mitral regurgitation, incomplete revascularization, and device therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              A total of 362 patients with ischemic cardiomyopathy (left ventricular dysfunction with &gt;70% stenosis in \u22651 epicardial coronary artery) underwent delayed hyperenhancement-magnetic resonance imaging and coronary angiography between 2002 and 2006. Total myocardial scar and peri-infarct (PI) area were measured using various threshold techniques. Multivariate survival analysis (primary end point of all-cause mortality) was conducted. One hundred fifty-seven deaths occurred during a mean 5.4-year follow-up (mean left ventricular ejection fraction, 23\u00b19%; mean end-systolic volume index, 113\u00b148 mL; mean total myocardial scar %, 25.5\u00b116.0%; mean PI%, 5.7\u00b12.9%). PI% (\u03b2=2.07;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) was an independent predictor of survival, independent of age, end-systolic volume, sex, mitral regurgitation, diabetes mellitus, dyslipidemia, coronary artery disease severity, implantable cardioverter defibrillator, and incomplete revascularization. PI% using 2 to 3 SD technique yielded the highest incremental prognostic power (\u03c7\n              <jats:sup>2<\/jats:sup>\n              score 149).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In advanced ischemic cardiomyopathy, PI% is a powerful independent and incremental predictor of all-cause mortality. Infarct heterogeneity offers substantial further risk stratification when compared with quantification of total myocardial scar % alone even after adjusting for clinical risk factors, end-systolic volume index, mitral regurgitation, incomplete revascularization, and implantable cardioverter defibrillator implantation.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.114.002077","type":"journal-article","created":{"date-parts":[[2014,8,2]],"date-time":"2014-08-02T07:55:58Z","timestamp":1406966158000},"page":"796-804","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":46,"title":["Infarct Characterization and Quantification by Delayed Enhancement Cardiac Magnetic Resonance Imaging Is a Powerful Independent and Incremental Predictor of Mortality in Patients With Advanced Ischemic Cardiomyopathy"],"prefix":"10.1161","volume":"7","author":[{"given":"Deborah H.","family":"Kwon","sequence":"first","affiliation":[{"name":"From the Heart and Vascular Institute (D.H.K., Z.B.P., K.K., M.R., M.D., S.D.F.) and Imaging Institute (D.H.K., Z.B.P., M.D., S.D.F.), Cleveland Clinic, OH; Department of Family Medicine, University of Colorado, Denver, CO (L.A.); and Menzies Research Institute of Tasmania, Hobart, Australia (T.H.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Asamoto","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute (D.H.K., Z.B.P., K.K., M.R., M.D., S.D.F.) and Imaging Institute (D.H.K., Z.B.P., M.D., S.D.F.), Cleveland Clinic, OH; Department of Family Medicine, University of Colorado, Denver, CO (L.A.); and Menzies Research Institute of Tasmania, Hobart, Australia (T.H.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoran B.","family":"Popovic","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute (D.H.K., Z.B.P., K.K., M.R., M.D., S.D.F.) and Imaging Institute (D.H.K., Z.B.P., M.D., S.D.F.), Cleveland Clinic, OH; Department of Family Medicine, University of Colorado, Denver, CO (L.A.); and Menzies Research Institute of Tasmania, Hobart, Australia (T.H.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenya","family":"Kusunose","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute (D.H.K., Z.B.P., K.K., M.R., M.D., S.D.F.) and Imaging Institute (D.H.K., Z.B.P., M.D., S.D.F.), Cleveland Clinic, OH; Department of Family Medicine, University of Colorado, Denver, CO (L.A.); and Menzies Research Institute of Tasmania, Hobart, Australia (T.H.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique","family":"Robinson","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute (D.H.K., Z.B.P., K.K., M.R., M.D., S.D.F.) and Imaging Institute (D.H.K., Z.B.P., M.D., S.D.F.), Cleveland Clinic, OH; Department of Family Medicine, University of Colorado, Denver, CO (L.A.); and Menzies Research Institute of Tasmania, Hobart, Australia (T.H.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milind","family":"Desai","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute (D.H.K., Z.B.P., K.K., M.R., M.D., S.D.F.) and Imaging Institute (D.H.K., Z.B.P., M.D., S.D.F.), Cleveland Clinic, OH; Department of Family Medicine, University of Colorado, Denver, CO (L.A.); and Menzies Research Institute of Tasmania, Hobart, Australia (T.H.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas H.","family":"Marwick","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute (D.H.K., Z.B.P., K.K., M.R., M.D., S.D.F.) and Imaging Institute (D.H.K., Z.B.P., M.D., S.D.F.), Cleveland Clinic, OH; Department of Family Medicine, University of Colorado, Denver, CO (L.A.); and Menzies Research Institute of Tasmania, Hobart, Australia (T.H.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott D.","family":"Flamm","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute (D.H.K., Z.B.P., K.K., M.R., M.D., S.D.F.) and Imaging Institute (D.H.K., Z.B.P., M.D., S.D.F.), Cleveland Clinic, OH; Department of Family Medicine, University of Colorado, Denver, CO (L.A.); and Menzies Research Institute of Tasmania, Hobart, Australia (T.H.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2008.09.010"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.508093"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.76.1.44"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2011-300060"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.01.052"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.108.826529"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.653568"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.106.613414"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-304261"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.111.084434"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2010.11.015"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.111.971549"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2929"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.852517"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.12.057"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)03567-4"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/circimaging.108.835793"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00250-8"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000150390.04704.B7"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211107"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1081\/JCMR-120030581"}],"container-title":["Circulation: Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCIMAGING.114.002077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T02:53:20Z","timestamp":1715568800000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCIMAGING.114.002077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,9]]}},"alternative-id":["10.1161\/CIRCIMAGING.114.002077"],"URL":"https:\/\/doi.org\/10.1161\/circimaging.114.002077","relation":{},"ISSN":["1941-9651","1942-0080"],"issn-type":[{"value":"1941-9651","type":"print"},{"value":"1942-0080","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9]]},"assertion":[{"value":"2014-02-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-07-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-08-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}