Left atrial volume and function measured by cardiac magnetic resonance imaging as predictors of shocks and mortality in patients with implantable cardioverter-defibrillators
| Autor: | Sheldon M. Singh, Payam Yazdan-Ashoori, Inna Y. Gong, Djeven P. Deva, Binita Riya Chacko, Nigel S. Tan, Iqwal Mangat, Tamar Shalmon, Saif Al-Mousawy, Paul Angaran, Andrew T. Yan, Luciano Folador, Laura Jimenez-Juan |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Univariate analysis Ejection fraction medicine.diagnostic_test business.industry medicine.medical_treatment Magnetic resonance imaging 030204 cardiovascular system & hematology Implantable cardioverter-defibrillator 03 medical and health sciences 0302 clinical medicine Cardiac magnetic resonance imaging Internal medicine Shock (circulatory) Cardiology Medicine Radiology Nuclear Medicine and imaging 030212 general & internal medicine medicine.symptom Cardiology and Cardiovascular Medicine business Cardiac imaging Cohort study |
| Zdroj: | The International Journal of Cardiovascular Imaging. 37:2259-2267 |
| ISSN: | 1573-0743 1569-5794 |
| Popis: | Left atrial (LA) volume and function (LA ejection fraction, LAEF) have demonstrated prognostic value in various cardiovascular diseases. We investigated the incremental value of LA volume and LAEF as measured by cardiovascular magnetic resonance imaging (CMR) for prediction of appropriate implantable cardioverter defibrillator (ICD) shock or all-cause mortality, in patients with ICD. We conducted a retrospective, multi-centre observational cohort study of patients who underwent CMR prior to primary or secondary prevention ICD implantation. A single, blinded reader measured maximum LA volume index (maxLAVi), minimum LA volume index (minLAVi), and LAEF. The primary outcome was a composite of independently adjudicated appropriate ICD shock or all-cause death. A total of 392 patients were enrolled. During a median follow-up time of 61 months, 140 (35.7%) experienced an appropriate ICD shock or died. Higher maxLAVi and minLAVi, and lower LAEF were associated with greater risk of appropriate ICD shock or death in univariate analysis. However, in multivariable analysis, LAEF (HR 0.92 per 10% higher, 95% CI 0.81–1.04, p = 0.17) and maxLAVi (HR 1.02 per 10 ml/m2 higher, 95% CI 0.93–1.12, p = 0.72) were not independent predictors of the primary outcome. In conclusion, LA volume and function measured by CMR were univariate but not independent predictors of appropriate ICD shocks or mortality. These findings do not support the routine assessment of LA volume and function to refine risk stratification to guide ICD implant. Larger studies with longer follow-up are required to further delineate the clinical implications of LA size and function. |
| Databáze: | OpenAIRE |
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