Impact of wideband cardiac magnetic resonance on diagnosis, decision-making and outcomes in patients with implantable cardioverter defibrillators.
cardiac magnetic resonance
implantable cardioverter defibrillators
late gadolinium enhancement
Journal
European heart journal. Cardiovascular Imaging
ISSN: 2047-2412
Titre abrégé: Eur Heart J Cardiovasc Imaging
Pays: England
ID NLM: 101573788
Informations de publication
Date de publication:
23 01 2023
23 01 2023
Historique:
received:
26
01
2022
revised:
01
09
2022
accepted:
21
10
2022
pubmed:
3
12
2022
medline:
25
1
2023
entrez:
2
12
2022
Statut:
ppublish
Résumé
Although myocardial scar assessment using late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) imaging is frequently indicated for patients with implantable cardioverter defibrillators (ICDs), metal artefact can degrade image quality. With the new wideband technique designed to mitigate device related artefact, CMR is increasingly used in this population. However, the common clinical indications for CMR referral and impact on clinical decision-making and prognosis are not well defined. Our study was designed to address these knowledge gaps. One hundred seventy-nine consecutive patients with an ICD (age 59 ± 13 years, 75% male) underwent CMR using cine and wideband pulse sequences for LGE imaging. Electronic medical records were reviewed to determine the reason for CMR referral, whether there was a change in clinical decision-making, and occurrence of major adverse cardiac events (MACEs). Referral indication was the most common evaluation of ventricular tachycardia (VT) substrate (n = 114, 64%), followed by cardiomyopathy (n = 53, 30%). Overall, CMR resulted in a new or changed diagnosis in 64 (36%) patients and impacted clinical management in 51 (28%). The effect on management change was highest in patients presenting with VT. A total of 77 patients (43%) experienced MACE during the follow-up period (median 1.7 years), including 65 in patients with evidence of LGE. Kaplan-Meier analysis showed that ICD patients with LGE had worse outcomes than those without LGE (P = 0.006). The clinical yield from LGE CMR is high and provides management changing and meaningful prognostic information in a significant proportion of patients with ICDs.
Identifiants
pubmed: 36458878
pii: 6862892
doi: 10.1093/ehjci/jeac227
pmc: PMC10226743
doi:
Substances chimiques
Contrast Media
0
Gadolinium
AU0V1LM3JT
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
181-189Subventions
Organisme : NHLBI NIH HHS
ID : T32 HL007381
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002389
Pays : United States
Organisme : NIH HHS
ID : 5UL1TR002389-02
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Déclaration de conflit d'intérêts
Conflict of interest: K.K. and A.R.P. have received research support from Philips. The other authors do not have any relevant disclosures.
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