Left Atrial Function Using Cardiovascular Magnetic Resonance Imaging Independently Predicts Life-Threatening Arrhythmias in Patients Referred to Receive a Primary Prevention Implantable Cardioverter Defibrillator.
Alberta
/ epidemiology
Arrhythmias, Cardiac
/ complications
Atrial Function, Left
/ physiology
Death, Sudden, Cardiac
/ epidemiology
Defibrillators, Implantable
Female
Follow-Up Studies
Heart Atria
/ diagnostic imaging
Humans
Incidence
Magnetic Resonance Imaging, Cine
/ methods
Male
Middle Aged
Primary Prevention
/ methods
Reproducibility of Results
Retrospective Studies
Risk Assessment
/ methods
Risk Factors
Journal
The Canadian journal of cardiology
ISSN: 1916-7075
Titre abrégé: Can J Cardiol
Pays: England
ID NLM: 8510280
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
13
09
2018
revised:
19
03
2019
accepted:
10
04
2019
entrez:
2
9
2019
pubmed:
2
9
2019
medline:
6
5
2020
Statut:
ppublish
Résumé
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; P < 0.001) 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.
Sections du résumé
BACKGROUND
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.
METHODS
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.
RESULTS
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; P < 0.001) 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.
CONCLUSIONS
LAEF is a simple, powerful, and independent predictor of SCD in patients being referred for primary prevention ICD implantation.
Identifiants
pubmed: 31472813
pii: S0828-282X(19)30288-0
doi: 10.1016/j.cjca.2019.04.015
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1149-1157Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.