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Prevalence and prognosis of ischaemic and non-ischaemic myocardial fibrosis in older adults

Shanbhag, S. M., Greve, A. M., Aspelund, T., Schelbert, E. B., Cao, J. J., Danielsen, R., Þorgeirsson, G., Sigurðsson, S., Eiríksdóttir, G., Harris, T. B., Launer, L. J., Guðnason, V., Arai, A. E. (2019).

By Anne Li, Research Assistant

Published in the European Heart Journal (2019), this first-of-its-kind study focused on determining the prevalence and prognosis of ischemic and non-ischemic myocardial fibrosis in a community-based sample of elderly patients. Cardiac magnetic resonance (CMR) is a well-established technique for detecting scar or fibrosis within the heart. Particular patterns of scar/fibrosis corresponding to heart attack and causes other than heart attack are useful for clinical purposes.

This large, NIH funded and conducted study recruited 900 subjects from Iceland. Dr. Jane Cao from St. Francis Hospital was a part of the research team and made significant contributions. The study established that in this population of elderly patients without pre-existing heart failure, those with scar have worse prognoses than those without myocardial scar. Major non-ischemic fibrosis/scar was found to be associated with a significantly greater risk of death or heart failure hospitalization than that of heart attack. These findings indicate that detrimental impact of the non-ischemic scarring is far greater than previously recognized, thereby highlighting the importance of non-ischemic scar detection and the need for more research on its etiology and potential courses of treatment.