High-risk imaging characteristics in left ventricular apex for the life-threatening arrhythmic events in Japanese hypertrophic cardiomyopathy patients.
Aged
Humans
Male
Aneurysm
Cardiomyopathy, Hypertrophic
/ complications
Contrast Media
Death, Sudden, Cardiac
/ etiology
Defibrillators, Implantable
East Asian People
Gadolinium
Risk Factors
Tachycardia, Ventricular
/ diagnosis
Ventricular Fibrillation
/ etiology
Female
Heart Aneurysm
/ diagnostic imaging
Heart Ventricles
/ diagnostic imaging
Cardiac magnetic resonance
Hypertrophic cardiomyopathy
Implantable cardioverter-defibrillator
Late gadolinium enhancement
Left ventricular aneurysm
Ventricular arrhythmia
Journal
Heart and vessels
ISSN: 1615-2573
Titre abrégé: Heart Vessels
Pays: Japan
ID NLM: 8511258
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
31
03
2023
accepted:
19
07
2023
medline:
27
10
2023
pubmed:
17
8
2023
entrez:
16
8
2023
Statut:
ppublish
Résumé
Left ventricular (LV) apical aneurysm is known to be associated with the life-threatening arrhythmic events in hypertrophic cardiomyopathy (HCM). However, the current 2014 ESC guideline has not included apical aneurysm as a major risk factor for sudden cardiac death and 2018 JCS guideline includes it only as a modulator, while it has been included as a new major risk marker in 2020 AHA/ACC guideline. Therefore, we sought to identify high-risk imaging characteristics in LV apex which is associated with a higher occurrence of ventricular tachycardia/fibrillation (VT/VF). In 99 consecutive Japanese HCM patients (median age, 65 years; 59 males) undergoing implantable cardioverter-defibrillator (ICD) implantation for primary prevention following cardiac magnetic resonance including late gadolinium enhancement (LGE), the occurrence of appropriate ICD interventions for VT/VF was evaluated for 6.2 (median) years after ICD implantation. Overall, appropriate ICD interventions occurred in 43% with annual rates of 7.0% for appropriate interventions. Kaplan-Meier analysis demonstrated that the presence of LV apical aneurysm was significantly associated with a higher occurrence of appropriate interventions (annual rates 18.9% vs. 6.4%, P = 0.013). Similarly, patients with high LV mid-to-apex pressure gradient (annual rates 14.9% vs. 6.2%, P = 0.022) and presence of apical LGE (annual rates 10.9% vs. 4.0%, P = 0.001) experienced appropriate interventions more frequently. An aneurysm, high-pressure gradient, and LGE in an apex are associated with VT/VF. These characteristics in apex should be kept in mind when implanting ICD in Japanese HCM patients as a primary prevention.
Identifiants
pubmed: 37587371
doi: 10.1007/s00380-023-02295-0
pii: 10.1007/s00380-023-02295-0
doi:
Substances chimiques
Contrast Media
0
Gadolinium
AU0V1LM3JT
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1442-1450Informations de copyright
© 2023. Springer Nature Japan KK, part of Springer Nature.
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