Late gadolinium enhancement in mitochondrial myopathy: a systematic review and meta-analysis of cardiovascular magnetic resonance studies.
G N de Medeiros, G G Berton, L M Visentini et al.
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In 30 seconds
This systematic review and meta-analysis pooled observational studies of late gadolinium enhancement (LGE) on cardiovascular magnetic resonance in patients with mitochondrial myopathy. Five studies involving 133 patients were included. The pooled prevalence of LGE was 20.72% (95% CI: 5.63%-41.00%), with high heterogeneity (I 2 = 81.1%). LGE was most commonly reported in the inferolateral region. The authors suggest that CMR may help detect cardiac involvement, while noting that the prognostic significance of LGE in this population remains to be clarified.
Key findings
- Across five studies and 133 patients, pooled LGE prevalence was 20.72% (95% CI: 5.63%-41.00%).
- Heterogeneity in pooled LGE prevalence was high (I 2 = 81.1%).
- Inferolateral LGE was most frequent (8.47%, 95% CI: 0.60%-21.65%); septal LGE was least frequent (2.76%, 95% CI: 0.13%-7.37%).
Why it matters
Cardiac involvement can occur in mitochondrial myopathy, and these pooled findings indicate that myocardial LGE is detectable in a proportion of affected patients. The regional pattern may help inform assessment of CMR findings, but the substantial heterogeneity and limited evidence mean prevalence estimates are uncertain. Whether LGE predicts clinical outcomes in this population is not established by this review.
What to keep in mind
Only five studies and 133 patients were included, and heterogeneity was high. The review notes that small samples and limited studies constrain interpretation.