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Add text on LGE and DMD.

• "In DMD patients, LGE occurs early, is progressive and increases with both age and decreasing LVEF. Segmentally, the incidence of the number of positive LGE segments increase with age and lower LVEF. Older patients and those who died during the study period had more septal LGE involvement. The current studies suggest that the time course and distribution of LGE-positivity may be an important clinical biomarker to aid in the management of DMD-associated cardiac disease." (ref: https://jcmr-online.biomedcentral.com/articles/10.1186/1532-429X-15-107)

Late gadolinium enhancement (LGE) is an assessment made with CMR imaging that includes gadolinium contrast administration. The test is done to assess for gadolinium contrast material accumulation in the tissue with increased extracellular space to determine both left and right ventricle fibrosis (ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801263/). For LGE, the assessment relates to the timing of the reading showing whether the contrast is present or not (shown as positive or negative). If the LGE is noted as present, more assessments may be done, such as presence per segment and the percentage of presence per segment. Since contrast is important to these assessments, the Procedure Agents (AG) dataset is shown with this example.increases over time for patients with DMD. Early onset LGE may be used as a prognostic factor since cardiac function has been shown to decline more rapidly for these patients.[5]

LGE assessments can
LGE assessments may be done on each of the cardiovascular segments as shown in Figure 1. https://www.ahajournals.org/doi/full/10.1161/hc0402.102975.[6]

The SDTM examples in this section show the findings of a CMR imaging procedure with late gadolinium enhancement. The level of granularity varies with the type of test used; research requirements will determine what level of granularity is needed.