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.