Prognostic Value of Nonischemic Ringlike Left Ventricular Scar in Patients With Apparently Idiopathic Nonsustained Ventricular Arrhythmias.

Adult Arrhythmias, Cardiac / diagnosis Female Heart Ventricles / physiopathology Humans Male Middle Aged Prognosis Retrospective Studies Survival Analysis
arrhythmias cardiac gadolinium magnetic resonance angiography prognosis

Journal

Circulation
ISSN: 1524-4539
Titre abrégé: Circulation
Pays: United States
ID NLM: 0147763

Informations de publication

Date de publication:
06 04 2021
Historique:
pubmed: 7 1 2021
medline: 29 12 2021
entrez: 6 1 2021
Statut: ppublish

Résumé

Left ventricular (LV) scar on late gadolinium enhancement (LGE) cardiac magnetic resonance has been correlated with life-threatening arrhythmic events in patients with apparently idiopathic ventricular arrhythmias (VAs). We investigated the prognostic significance of a specific LV-LGE phenotype characterized by a ringlike pattern of fibrosis. A total of 686 patients with apparently idiopathic nonsustained VA underwent contrast-enhanced cardiac magnetic resonance. A ringlike pattern of LV scar was defined as LV subepicardial/midmyocardial LGE involving at least 3 contiguous segments in the same short-axis slice. The end point of the study was time to the composite outcome of all-cause death, resuscitated cardiac arrest because of ventricular fibrillation or hemodynamically unstable ventricular tachycardia and appropriate implantable cardioverter defibrillator therapy. A total of 28 patients (4%) had a ringlike pattern of scar (group A), 78 (11%) had a non-ringlike pattern (group B), and 580 (85%) had normal cardiac magnetic resonance with no LGE (group C). Group A patients were younger compared with groups B and C (median age, 40 vs 52 vs 45 years; In patients with apparently idiopathic nonsustained VA, nonischemic LV scar with a ringlike pattern is associated with malignant arrhythmic events.

Sections du résumé

BACKGROUND
Left ventricular (LV) scar on late gadolinium enhancement (LGE) cardiac magnetic resonance has been correlated with life-threatening arrhythmic events in patients with apparently idiopathic ventricular arrhythmias (VAs). We investigated the prognostic significance of a specific LV-LGE phenotype characterized by a ringlike pattern of fibrosis.
METHODS
A total of 686 patients with apparently idiopathic nonsustained VA underwent contrast-enhanced cardiac magnetic resonance. A ringlike pattern of LV scar was defined as LV subepicardial/midmyocardial LGE involving at least 3 contiguous segments in the same short-axis slice. The end point of the study was time to the composite outcome of all-cause death, resuscitated cardiac arrest because of ventricular fibrillation or hemodynamically unstable ventricular tachycardia and appropriate implantable cardioverter defibrillator therapy.
RESULTS
A total of 28 patients (4%) had a ringlike pattern of scar (group A), 78 (11%) had a non-ringlike pattern (group B), and 580 (85%) had normal cardiac magnetic resonance with no LGE (group C). Group A patients were younger compared with groups B and C (median age, 40 vs 52 vs 45 years;
CONCLUSIONS
In patients with apparently idiopathic nonsustained VA, nonischemic LV scar with a ringlike pattern is associated with malignant arrhythmic events.

Identifiants

DOI: 10.1161/CIRCULATIONAHA.120.047640 PMID: 33401956
pubmed: 33401956
doi: 10.1161/CIRCULATIONAHA.120.047640
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1359-1373

Commentaires et corrections

Type : CommentIn

Auteurs

Daniele Muser (D)

Cardiac Electrophysiology, Cardiovascular Division (D.M., S.A.C., I.L., A.E., J.J.L., S.D., R.D., F.C.G., D.J.C., D.S.F., F.E.M., P.S.), Hospital of the University of Pennsylvania, Philadelphia.

Gaetano Nucifora (G)

Daniele Muser (D)

Cardiothoracic Department, Udine Civil Hospital, Italy (D.M.).

Gaetano Nucifora (G)

Cardiac Imaging Unit, Wythenshawe Hospital, Manchester University National Health Service Foundation Trust, United Kingdom (G.N.).

Maurizio Pieroni (M)

Cardiovascular Department, San Donato Hospital, Arezzo, Italy (M.P.).

Simon A Castro (SA)

Cardiac Electrophysiology, Cardiovascular Division (D.M., S.A.C., I.L., A.E., J.J.L., S.D., R.D., F.C.G., D.J.C., D.S.F., F.E.M., P.S.), Hospital of the University of Pennsylvania, Philadelphia.

Ruben Casado Arroyo (R)

Cardiology Department, Université Libre de Bruxelles, Belgium (R.C.A.).

Shingo Maeda (S)

Arrhythmia Advanced Therapy Center, AOI Universal Hospital, Kanagawa, Japan (S.M.).

Daniel A Benhayon (DA)

Cardiac Electrophysiology, Memorial Healthcare System, Hollywood, FL (D.A.B.).

Ioan Liuba (I)

Cardiac Electrophysiology, Cardiovascular Division (D.M., S.A.C., I.L., A.E., J.J.L., S.D., R.D., F.C.G., D.J.C., D.S.F., F.E.M., P.S.), Hospital of the University of Pennsylvania, Philadelphia.
Division of Electrophysiology, Department of Cardiology, University Hospital Linköping, Sweden (I.L.).

Mouhannad Sadek (M)

Cardiac Electrophysiology, University of Ottawa Heart Institute, Ontario, Canada (M.S.).

Silvia Magnani (S)

Cardiac Electrophysiology/Heart Rhythm Center, New York University (S.M.).
Cardiovascular Medicine Division, San Paolo Hospital, Milan, Italy (S.M.).

Andres Enriquez (A)

Cardiac Electrophysiology, Cardiovascular Division (D.M., S.A.C., I.L., A.E., J.J.L., S.D., R.D., F.C.G., D.J.C., D.S.F., F.E.M., P.S.), Hospital of the University of Pennsylvania, Philadelphia.

Jackson J Liang (JJ)

Cardiac Electrophysiology, Cardiovascular Division (D.M., S.A.C., I.L., A.E., J.J.L., S.D., R.D., F.C.G., D.J.C., D.S.F., F.E.M., P.S.), Hospital of the University of Pennsylvania, Philadelphia.

Biagio Sassone (B)

Division of Cardiology, SS.ma Annunziata Hospital, Department of Translational Medicine, University of Ferrara, Italy (B.S.).

Benoit Desjardins (B)

Radiology Department (B.D.), Hospital of the University of Pennsylvania, Philadelphia.

Sanjay Dixit (S)

Cardiac Electrophysiology, Cardiovascular Division (D.M., S.A.C., I.L., A.E., J.J.L., S.D., R.D., F.C.G., D.J.C., D.S.F., F.E.M., P.S.), Hospital of the University of Pennsylvania, Philadelphia.

Rajat Deo (R)

Cardiac Electrophysiology, Cardiovascular Division (D.M., S.A.C., I.L., A.E., J.J.L., S.D., R.D., F.C.G., D.J.C., D.S.F., F.E.M., P.S.), Hospital of the University of Pennsylvania, Philadelphia.

Fermin C Garcia (FC)

Cardiac Electrophysiology, Cardiovascular Division (D.M., S.A.C., I.L., A.E., J.J.L., S.D., R.D., F.C.G., D.J.C., D.S.F., F.E.M., P.S.), Hospital of the University of Pennsylvania, Philadelphia.

David J Callans (DJ)

Cardiac Electrophysiology, Cardiovascular Division (D.M., S.A.C., I.L., A.E., J.J.L., S.D., R.D., F.C.G., D.J.C., D.S.F., F.E.M., P.S.), Hospital of the University of Pennsylvania, Philadelphia.

David S Frankel (DS)

Cardiac Electrophysiology, Cardiovascular Division (D.M., S.A.C., I.L., A.E., J.J.L., S.D., R.D., F.C.G., D.J.C., D.S.F., F.E.M., P.S.), Hospital of the University of Pennsylvania, Philadelphia.

Joseph B Selvanayagam (JB)

Department of Cardiovascular Medicine, Flinders Medical Centre, Flinders University, Bedford Park, Adelaide, South Australia (J.B.S.).

Francis E Marchlinski (FE)

Cardiac Electrophysiology, Cardiovascular Division (D.M., S.A.C., I.L., A.E., J.J.L., S.D., R.D., F.C.G., D.J.C., D.S.F., F.E.M., P.S.), Hospital of the University of Pennsylvania, Philadelphia.

Pasquale Santangeli (P)

Cardiac Electrophysiology, Cardiovascular Division (D.M., S.A.C., I.L., A.E., J.J.L., S.D., R.D., F.C.G., D.J.C., D.S.F., F.E.M., P.S.), Hospital of the University of Pennsylvania, Philadelphia.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Prognostic Value of Nonischemic Ringlike Left...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Prognostic Value of Nonischemic Ringlike Left...
questionsmedicales.fr › Système cardiovasculaire › Coeur › Ventricules cardiaques › Prognostic Value of Nonischemic Ringlike Left...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Prognostic Value of Nonischemic Ringlike Left...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Prognostic Value of Nonischemic Ringlike Left...
questionsmedicales.fr › Diagnostic › Pronostic › Prognostic Value of Nonischemic Ringlike Left...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Prognostic Value of Nonischemic Ringlike Left...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de survie › Prognostic Value of Nonischemic Ringlike Left...