Late gadolinium enhancement and the risk of ventricular arrhythmias and sudden death in NYHA class I patients with non-ischaemic cardiomyopathy.

Autor: Di Marco A; Department of Cardiology, Hospital Universitari de Bellvitge, Barcelona, Spain.; Bioheart-Cardiovascular Diseases Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain.; Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK., Brown P; Department of Cardiology, North West Heart Centre, Manchester University NHS Foundation Trust, Manchester, UK., Mateus G; Department of Cardiology, Hospital Universitari de Bellvitge, Barcelona, Spain., Faga V; Department of Cardiology, Hospital Universitari de Bellvitge, Barcelona, Spain.; Bioheart-Cardiovascular Diseases Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain., Nucifora G; Department of Cardiology, North West Heart Centre, Manchester University NHS Foundation Trust, Manchester, UK., Claver E; Department of Cardiology, Hospital Universitari de Bellvitge, Barcelona, Spain.; Bioheart-Cardiovascular Diseases Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain., Viedma J; Department of Cardiology, Hospital Universitari de Bellvitge, Barcelona, Spain., Galvan F; Department of Cardiology, Hospital Universitari de Bellvitge, Barcelona, Spain., Bradley J; Department of Cardiology, North West Heart Centre, Manchester University NHS Foundation Trust, Manchester, UK., Dallaglio PD; Department of Cardiology, Hospital Universitari de Bellvitge, Barcelona, Spain.; Bioheart-Cardiovascular Diseases Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain., de Frutos F; Department of Cardiology, Hospital Universitari de Bellvitge, Barcelona, Spain.; Bioheart-Cardiovascular Diseases Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain., Miller CA; Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.; Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.; Wellcome Centre for Cell-Matrix Research, Division of Cell-Matrix Biology & Regenerative Medicine, School of Biology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK., Comín-Colet J; Department of Cardiology, Hospital Universitari de Bellvitge, Barcelona, Spain.; Bioheart-Cardiovascular Diseases Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain.; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain., Anguera I; Department of Cardiology, Hospital Universitari de Bellvitge, Barcelona, Spain.; Bioheart-Cardiovascular Diseases Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain., Schmitt M; Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.; Department of Cardiology, North West Heart Centre, Manchester University NHS Foundation Trust, Manchester, UK.
Jazyk: angličtina
Zdroj: European journal of heart failure [Eur J Heart Fail] 2023 May; Vol. 25 (5), pp. 740-750. Date of Electronic Publication: 2023 Feb 22.
DOI: 10.1002/ejhf.2793
Abstrakt: Aim: To compare the risk of ventricular arrhythmias (VA) and sudden death (SD) between New York Heart Association (NYHA) class I and NYHA class II-III patients with non-ischaemic cardiomyopathy (NICM).
Methods and Results: Observational retrospective cohort study including patients with NICM who underwent cardiac magnetic resonance at two hospitals. The primary endpoint included appropriate implantable cardioverter defibrillator (ICD) therapies, sustained ventricular tachycardia, resuscitated cardiac arrest and SD. The secondary endpoint included heart failure (HF) hospitalizations, heart transplant, left ventricular assist device implant or HF death. Overall, 698 patients were included, 33% in NYHA class I. During a median follow-up of 31 months, the primary endpoint occurred in 57 patients (8%), with no differences between NYHA class I and NYHA class II-III cases (7% vs. 9%, p = 0.62). Late gadolinium enhancement (LGE) was the only independent predictor of the primary outcome both in NYHA class I and NYHA class II-III patients. LGE+ NYHA class I patients had a similar cumulative incidence of the primary endpoint as compared to LGE+ NYHA class II-III (p = 0.92) and a significantly higher risk as compared to LGE- NYHA class II-III cases (p < 0.001). The risk of the secondary endpoint was significantly higher in patients in NYHA class II-III as compared to those in NYHA class I (hazard ratio 3.2, p = 0.001).
Conclusions: Patients with NICM in NYHA class I are not necessarily at low risk of VA and SD. Actually, LGE+ NYHA class I patients have a high risk. NYHA class I patients with high-risk factors, such as LGE, could benefit from primary prevention ICD at least as much as those in NYHA class II-III with the same risk factors.
(© 2023 European Society of Cardiology.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje