{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1362262946170750720.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.1161/circulationaha.107.727826"}},{"identifier":{"@type":"URI","@value":"https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.107.727826"}}],"dc:title":[{"@value":"Incidence and Prognostic Implication of Unrecognized Myocardial Scar Characterized by Cardiac Magnetic Resonance in Diabetic Patients Without Clinical Evidence of Myocardial Infarction"}],"description":[{"type":"abstract","notation":[{"@value":"<jats:p>\n                    <jats:bold>\n                      <jats:italic>Background—</jats:italic>\n                    </jats:bold>\n                    Silent myocardial infarctions (MIs) are prevalent among diabetic patients and inflict significant morbidity and mortality. Although late gadolinium enhancement (LGE) imaging by cardiac magnetic resonance (CMR) can provide sensitive characterization of myocardial scar, its prognostic significance in diabetic patients without any clinical evidence of MI is unknown.\n                  </jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Methods and Results—</jats:italic>\n                    </jats:bold>\n                    We performed clinically indicated CMR imaging in 187 diabetic patients who were grouped by the absence (study group, n=109) or presence (control group, n=78) of clinical evidence of MI (clinical history of MI or Q waves on ECG). CMR imaging and follow-up were successful in 107 study patients (98%) and 74 control patients (95%). Cox regression analyses were performed to associate LGE with major adverse cardiovascular events (MACE), including death, acute MI, new congestive heart failure or unstable angina, stroke, and significant ventricular arrhythmias. LGE by CMR was present in 30 of 107 study patients (28%). At a median follow-up of 17 months, 38 of 107 patients (36%) experienced MACE, which included 18 deaths. Presence of LGE was associated with a >3-fold hazards increase for MACE and for death (hazard ratio, 3.71 and 3.61;\n                    <jats:italic>P</jats:italic>\n                    <0.001 and\n                    <jats:italic>P</jats:italic>\n                    =0.007, respectively). Adjusted to a model that combines patient age, sex, ST or T changes on ECG, and left ventricular end-systolic volume index, LGE maintained a >4-fold hazards increase for MACE (adjusted hazard ratio, 4.13; 95% confidence interval, 1.74 to 9.79;\n                    <jats:italic>P</jats:italic>\n                    =0.001). In addition, LGE provided significant prognostic value with MACE and with death adjusted to a diabetic-specific risk model for 5-year events. The presence of LGE was the strongest multivariable predictor of MACE and death by stepwise selection in the study patients.\n                  </jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Conclusions—</jats:italic>\n                    </jats:bold>\n                    CMR imaging can characterize occult myocardial scar consistent with MI in diabetic patients without clinical evidence of MI. This imaging finding demonstrates strong association with MACE and mortality hazards that is incremental to clinical, ECG, and left ventricular function combined.\n                  </jats:p>"}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1382262946170750593","@type":"Researcher","foaf:name":[{"@value":"Raymond Y. Kwong"}],"jpcoar:affiliationName":[{"@value":"From the Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Mass (R.Y.K., H.S., H.W., G.V., V.G., K.S.); Division of Cardiology, Department of Medicine, University of Western Ontario, London, Ontario, Canada (S.S.); and Cardiology Unit, University of Vermont College of Medicine, Burlington (K.A.B.)."}]},{"@id":"https://cir.nii.ac.jp/crid/1382262946170750724","@type":"Researcher","foaf:name":[{"@value":"Hamid Sattar"}],"jpcoar:affiliationName":[{"@value":"From the Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Mass (R.Y.K., H.S., H.W., G.V., V.G., K.S.); Division of Cardiology, Department of Medicine, University of Western Ontario, London, Ontario, Canada (S.S.); and Cardiology Unit, University of Vermont College of Medicine, Burlington (K.A.B.)."}]},{"@id":"https://cir.nii.ac.jp/crid/1382262946170750721","@type":"Researcher","foaf:name":[{"@value":"Henry Wu"}],"jpcoar:affiliationName":[{"@value":"From the Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Mass (R.Y.K., H.S., H.W., G.V., V.G., K.S.); Division of Cardiology, Department of Medicine, University of Western Ontario, London, Ontario, Canada (S.S.); and Cardiology Unit, University of Vermont College of Medicine, Burlington (K.A.B.)."}]},{"@id":"https://cir.nii.ac.jp/crid/1382262946170750592","@type":"Researcher","foaf:name":[{"@value":"Gabriel Vorobiof"}],"jpcoar:affiliationName":[{"@value":"From the Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Mass (R.Y.K., H.S., H.W., G.V., V.G., K.S.); Division of Cardiology, Department of Medicine, University of Western Ontario, London, Ontario, Canada (S.S.); and Cardiology Unit, University of Vermont College of Medicine, Burlington (K.A.B.)."}]},{"@id":"https://cir.nii.ac.jp/crid/1382262946170750594","@type":"Researcher","foaf:name":[{"@value":"Vijay Gandla"}],"jpcoar:affiliationName":[{"@value":"From the Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Mass (R.Y.K., H.S., H.W., G.V., V.G., K.S.); Division of Cardiology, Department of Medicine, University of Western Ontario, London, Ontario, Canada (S.S.); and Cardiology Unit, University of Vermont College of Medicine, Burlington (K.A.B.)."}]},{"@id":"https://cir.nii.ac.jp/crid/1382262946170750722","@type":"Researcher","foaf:name":[{"@value":"Kevin Steel"}],"jpcoar:affiliationName":[{"@value":"From the Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Mass (R.Y.K., H.S., H.W., G.V., V.G., K.S.); Division of Cardiology, Department of Medicine, University of Western Ontario, London, Ontario, Canada (S.S.); and Cardiology Unit, University of Vermont College of Medicine, Burlington (K.A.B.)."}]},{"@id":"https://cir.nii.ac.jp/crid/1382262946170750723","@type":"Researcher","foaf:name":[{"@value":"Samuel Siu"}],"jpcoar:affiliationName":[{"@value":"From the Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Mass (R.Y.K., H.S., H.W., G.V., V.G., K.S.); Division of Cardiology, Department of Medicine, University of Western Ontario, London, Ontario, Canada (S.S.); and Cardiology Unit, University of Vermont College of Medicine, Burlington (K.A.B.)."}]},{"@id":"https://cir.nii.ac.jp/crid/1382262946170750720","@type":"Researcher","foaf:name":[{"@value":"Kenneth A. Brown"}],"jpcoar:affiliationName":[{"@value":"From the Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Boston, Mass (R.Y.K., H.S., H.W., G.V., V.G., K.S.); Division of Cardiology, Department of Medicine, University of Western Ontario, London, Ontario, Canada (S.S.); and Cardiology Unit, University of Vermont College of Medicine, Burlington (K.A.B.)."}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"00097322"},{"@type":"EISSN","@value":"15244539"}],"prism:publicationName":[{"@value":"Circulation"}],"dc:publisher":[{"@value":"Ovid Technologies (Wolters Kluwer Health)"}],"prism:publicationDate":"2008-09-02","prism:volume":"118","prism:number":"10","prism:startingPage":"1011","prism:endingPage":"1020"},"reviewed":"false","url":[{"@id":"https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.107.727826"}],"createdAt":"2008-08-25","modifiedAt":"2024-05-13","relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360002215384634752","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Diabetic cardiomyopathy: pathophysiology and clinical features"}]},{"@id":"https://cir.nii.ac.jp/crid/1360009142795216640","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"High prevalence of fragmented QRS on electrocardiography in Japanese subjects with diabetes irrespective of metabolic syndrome"}]},{"@id":"https://cir.nii.ac.jp/crid/1360567186039034496","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Additional diagnostic value of first-pass myocardial perfusion imaging without stress when combined with 64-row detector coronary CT angiography in patients with coronary artery disease"}]},{"@id":"https://cir.nii.ac.jp/crid/1390001205102318848","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Cardiac MRI in Ischemic Heart Disease"}]},{"@id":"https://cir.nii.ac.jp/crid/1390001205763031040","@type":"Article","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Advanced Noninvasive Cardiac Imaging using Cardiac Magnetic Resonance Imaging in the Diagnosis and Evaluation of Coronary Artery Disease"}]},{"@id":"https://cir.nii.ac.jp/crid/1390282680081667968","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Cardiac Magnetic Resonance Imaging: Choice of the Year  - Which Imaging Modality Is Best for Evaluation of Myocardial Ischemia? 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