Advanced Echocardiographic Imaging for Prediction of SCD in Moderate and Severe LV Systolic Function
| Autor: | Rebecca Perry, Matthew Horsfall, Majo X. Joseph, Anand N. Ganesan, Noor Darinah Mohd Daril, Sanjana Patil, Gaetano Nucifora, Kathryn Tiver, Christian Marx, Joseph B. Selvanayagam, Andrew D. McGavigan, Derek P. Chew, Karthigesh Sree Raman |
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| Přispěvatelé: | Perry, Rebecca, Patil, Sanjana, Marx, Christian, Horsfall, Matthew, Chew, Derek P, Raman, Karthigesh Sree, Daril, Noor Darinah Mohd, Tiver, Kathryn, Joseph, Majo X, Ganesan, Anand N, McGavigan, Andrew, Nucifora, Gaetano, Selvanayagam, Joseph B |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Systole 030204 cardiovascular system & hematology Risk Assessment Severity of Illness Index sudden cardiac death Ventricular Function Left 030218 nuclear medicine & medical imaging Sudden cardiac death Ventricular Dysfunction Left 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Interquartile range Internal medicine South Australia mechanical dispersion medicine echocardiography Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Aged Retrospective Studies Ejection fraction business.industry Hazard ratio Reproducibility of Results Stroke Volume Middle Aged Prognosis medicine.disease Confidence interval Death Sudden Cardiac Echocardiography Cohort cardiovascular system Etiology Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | JACC: Cardiovascular Imaging. 13:604-612 |
| ISSN: | 1936-878X |
| Popis: | Objectives: This study sought to determine the long-term prognostic value of myocardial deformation imaging by echocardiography in risk stratification of sudden cardiac death (SCD) and malignant ventricular arrhythmias (VAs) in a large consecutive cohort of patients with left ventricular (LV) systolic impairment, irrespective of its etiology. Background: Left ventricular ejection fraction (LVEF) is limited for prediction of SCD. Echocardiographic strain-derived mechanical dispersion (MD) and global longitudinal strain (GLS) has been linked to VA and SCD. However, due to low event rates, the role of these parameters has not been fully elucidated. Methods: Consecutive clinically stable patients who underwent echocardiographic study performed in an outpatient setting from 2008 to 2014 with a Simpson left ventricular ejection fraction (LVEF) ≤45% were included in the study. Strain analysis was performed in which the LV was separated into 16 segments for regional analysis. Mechanical dispersion (MD) was calculated as the SD of the time to peak of each of the 16 regions. Outcome data were obtained from medical records. Results: A total of 939 patients were included in the study, with median LVEF of 37% (interquartile range 30% to 42%). At follow-up (91.4 ± 23.4 months), 96 VA events had occurred. Multivariate analysis demonstrated that only MD ≥75 ms (hazard ratio: 9.45; 95% confidence interval: 4.75 to 18.81; p < 0.0001) was predictive of VA events. Low MD predicted a low event rate, irrespective of LVEF. Conclusions: Using LVEF alone is inferior for prediction of VA and SCD, particularly in patients with moderately reduced LVEF. MD is easily obtained from standard echocardiographic images and can be used to improve risk prognosis, particularly in patients who are currently excluded from cardiac defibrillator insertion based on LVEF. usc Refereed/Peer-reviewed |
| Databáze: | OpenAIRE |
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