Left Atrial Function Using Cardiovascular Magnetic Resonance Imaging Independently Predicts Life-Threatening Arrhythmias in Patients Referred to Receive a Primary Prevention Implantable Cardioverter Defibrillator

Autor: Archa Rajagopalan, Andrew Roberts, Yoko Mikami, Kai Homer, Punitha Arasaratnam, Andrew G Howarth, Bobak Heydari, Mingkai Peng, Karen Cowan, Carmen P Lydell, James A. White, Aidan Cornhill, Derek V. Exner, Claire Sumner
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
medicine.medical_treatment
Magnetic Resonance Imaging
Cine
030204 cardiovascular system & hematology
Risk Assessment
Alberta
Sudden cardiac death
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Humans
Heart Atria
030212 general & internal medicine
Retrospective Studies
Ejection fraction
medicine.diagnostic_test
business.industry
Incidence
Incidence (epidemiology)
Hazard ratio
Reproducibility of Results
Arrhythmias
Cardiac
Retrospective cohort study
Magnetic resonance imaging
Middle Aged
Implantable cardioverter-defibrillator
medicine.disease
Defibrillators
Implantable
Primary Prevention
Death
Sudden
Cardiac
Shock (circulatory)
Cardiology
Atrial Function
Left
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: Canadian Journal of Cardiology. 35:1149-1157
ISSN: 0828-282X
DOI: 10.1016/j.cjca.2019.04.015
Popis: In this study we aimed to investigate left atrial (LA) function, measured from routine cine cardiovascular magnetic resonance imaging, to determine its value for the prediction of sudden cardiac death (SCD) or appropriate implantable cardioverter defibrillator (ICD) shock in patients who received primary prevention ICD implantation.We studied 203 patients with ischemic or idiopathic nonischemic dilated cardiomyopathy who underwent cardiovascular magnetic resonance imaging before primary prevention ICD implantation. LA volumes were measured at end-diastole and end-systole from 4- and 2-chamber cine images, and LA emptying function (LAEF) calculated. Patients were followed for the primary composite end point of SCD or appropriate ICD shock.Mean age was 61 ± 12 years with a mean left ventricular ejection fraction of 24 ± 7%. The mean LAEF was 27 ± 15% (range, 0.9%-73%). At a median follow-up of 1639 days, 35 patients (17%) experienced the primary composite outcome. LAEF was strongly associated with the primary outcome (P = 0.001); patients with an LAEF ≤ 30% experienced a cumulative event rate of 26.1% vs 5.7% (hazard ratio, 5.5; P0.001) in patients above this cutoff. This finding was maintained in multivariable analysis (hazard ratio, 4.7; P = 0.002) and was consistently shown in the ischemic and nonischemic dilated cardiomyopathy subgroups.LAEF is a simple, powerful, and independent predictor of SCD in patients being referred for primary prevention ICD implantation.
Databáze: OpenAIRE
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