Diagnostic and Prognostic Role of Cardiac Magnetic Resonance Before Implantable Cardioverter Defibrillator
| Autor: | Alessandro Comella, Marco Tullio Baratto, Massimo Magnacca, Alessio Lilli, Gianluca Solarino, Maria Laura Canale, Jacopo Del Meglio, Giancarlo Casolo, Luca Salvatori, Claudio Vignali, Carlo Tessa, Rosa Poddighe |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Magnetic Resonance Imaging Cine 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Humans In patient Clinical significance cardiovascular diseases 030212 general & internal medicine Prospective Studies Aged business.industry Clinical events Reproducibility of Results Arrhythmias Cardiac Stroke Volume Tissue characterization musculoskeletal system Implantable cardioverter-defibrillator Prognosis Icd implantation Defibrillators Implantable cardiovascular system Cardiology Clinical value Female Cardiology and Cardiovascular Medicine business Cardiac magnetic resonance circulatory and respiratory physiology Follow-Up Studies |
| Zdroj: | The American journal of cardiology. 123(5) |
| ISSN: | 1879-1913 |
| Popis: | The use of cardiac magnetic resonance (cMR) to assess remodeling and tissue characterization in primitive and secondary cardiomyopathies has progressively increased, and it carries important prognostic informations. The aim of this study was to assess the overall clinical value of cMR before implantable cardioverter defibrillator (ICD). All patients referred to our center for an ICD implantation and submitted to cMR (n = 134) were analyzed. All the cMR diagnostic findings and following clinical events were reviewed to assess clinical relevance in patients care. The use of cMR before ICD implantation has progressively increased during the decade studied (13% to 53%, p0.001). Subjects who underwent cMR were younger, more often female, with lower NYHA class and higher ejection fraction (p0.05 for all). Unexpected diagnostic findings were observed in 34 patients (25%), resulting in an immediate therapeutic strategy modification in 13%. A pattern of fibrosis leading to a change in the disease's etiology and thrombus detection were the most frequent cMR findings, followed by anatomical incidental findings. Any grade of fibrosis carried a higher annual incidence of combined death or ventricular arrhythmias (9.92% vs 1.83%, p = 0.02). Annual event rate was related to the extent of scarring. In conclusion, we observed a progressively increase of cMR utilization before ICD implantation during the last decade. This practice has yielded a significant increase of new diagnostic findings, carrying unique prognostic information linked to tissue characterization. |
| Databáze: | OpenAIRE |
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