Looking for appropriate criterias for SCD prevention: prognostic role of MRI in patients with nonischemic ventricular arrhythmias
| Autor: | N.I. Bulaeva, B Berdibekov, O I Gromova, S.A. Aleksandrova, Elena Z. Golukhova |
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| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | European Heart Journal. 42 |
| ISSN: | 1522-9645 0195-668X |
| Popis: | Background Currently left ventricular ejection fraction (LVEF) remains the only indicator for identifying candidates for implantable cardioverter-defibrillator (ICD)therapy for the primary prevention of sudden cardiac death (SCD). However the majority of patients suffering SCD have a preserved LVEF and some of them with poor LVEF do not benefit from ICD therapy. Late gadolinium enhancement (LGE) on cardiac-MRI (CMR) has been proposed as an independent predictor of ventricular arrhythmias. Limited data exist on the role and methods of LGE quantification in patients with a nonischemic ventricular arrhythmias. Purpose The goal of this study is to explore whether theextent of LGE would improve risk stratification in patients with a nonischemic ventricular arrhythmias with an indication for implantable cardioverter-defibrillator (ICD) therapy for the primary or secondary prevention of SCD. Methods Fifty six patients with a nonischemic ventricular arrhythmias underwent LGE-CMR prior to ICD implantation for primary and secondary prevention of SCD. LGE extent was quantified using both the full-width half-maximum (FWHM) andthe standard deviation–based (2-SD) method. The primary endpoint was appropriate ICD discharge for sustained ventricular tachyarrhythmia. Results During a median follow-up of 18 [11,5–26,0] months the primary endpoint occurred in 22 patients. The median percentage of LV myocardium fibrosis assessed by the 2-SD method was 9,8 [6,0–18,8]%, while for the FWHM method it was 5,1 [3,0–10,6]% (p Conclusions FWHM is the optimal semi-automated quantification method in patients with nonischemic ventricular arrhythmias, demonstrating the highest technical consistency. LGE extent is an independent predictor of adverse outcomes in patients with nonischemic ventricular arrhythmia and may have an important role in risk stratification. Funding Acknowledgement Type of funding sources: None. LGE QuantificationEvent-Free Survival |
| Databáze: | OpenAIRE |
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