BACKGROUND: The prognostic implications of late gadolinium enhancement (LGE) 
have been evaluated in ischemic and non-ischemic cardiomyopathies. The present 
study analyzed LGE distribution in patients with end-stage hypertrophic 
cardiomyopathy (ES-HCM) and with dilated cardiomyopathy (DCM), and tried to 
identify high risk patients in DCM.
METHODS: Eleven patients with ES-HCM and 72 with DCM underwent cine- and 
LGE-cardiac magnetic resonance and ultrasound cardiography. The patient outcome 
was analyzed retrospectively for 5years of follow-up.
RESULTS: LGE distributed mainly in the inter-ventricular septum, but spread more 
diffusely into other left ventricular segments in patients with ES-HCM and in a 
certain part of patients with DCM. Thus, patients with DCM can be divided into 
three groups according to LGE distribution; no LGE (n=24), localized LGE 
(localized at septum, n=36), and extensive LGE (spread into other segments, 
n=12). Reverse remodeling occurred after treatment in patients with no LGE and 
with localized LGE, but did not in patients with extensive LGE and with ES-HCM. 
The event-free survival rate for composite outcome (cardiac death, 
hospitalization for decompensated heart failure or ventricular arrhythmias) was 
lowest in patients with extensive LGE (92%, 74% and 42% in no LGE, localized 
LGE, and extensive LGE, p=0.02 vs. no LGE), and was comparable to that in 
patients with ES-HCM (42%).
CONCLUSIONS: In DCM, patients with extensive LGE showed no functional recovery 
and the lowest event-free survival rate that were comparable to patients with 
ES-HCM. The analysis of LGE distribution may be valuable to predict reverse 
remodeling and to identify high-risk patients.