Prognostic Role of Late Gadolinium Enhancement in Patients With Hypertrophic Cardiomyopathy and Low-to-Intermediate Sudden Cardiac Death Risk Score
Sudden cardiac death (SCD) is the most life-threating complication of hypertrophic cardiomyopathy. Guidelines of the European Society of Cardiology (ESC) suggest the implantation of an implantable cardioverter defibrillator in primary prevention according to a 5-year risk SCD score ≥6%. The aim of t...
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| Veröffentlicht in: | The American journal of cardiology 2019-10, Vol.124 (8), p.1286-1292 |
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| creator | Todiere, Giancarlo Nugara, Cinzia Gentile, Giovanni Negri, Francesco Bianco, Francesco Falletta, Calogero Novo, Giuseppina Di Bella, Gianluca De Caterina, Raffaele Zachara, Elisabetta Re, Federica Clemenza, Francesco Sinagra, Gianfranco Emdin, Michele Aquaro, Giovanni Donato |
| description | Sudden cardiac death (SCD) is the most life-threating complication of hypertrophic cardiomyopathy. Guidelines of the European Society of Cardiology (ESC) suggest the implantation of an implantable cardioverter defibrillator in primary prevention according to a 5-year risk SCD score ≥6%. The aim of the study is to evaluate the prognostic role of late gadolinium enhancement (LGE) in patients with a 5-year risk SCD score |
| doi_str_mv | 10.1016/j.amjcard.2019.07.023 |
| format | Article |
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Guidelines of the European Society of Cardiology (ESC) suggest the implantation of an implantable cardioverter defibrillator in primary prevention according to a 5-year risk SCD score ≥6%. The aim of the study is to evaluate the prognostic role of late gadolinium enhancement (LGE) in patients with a 5-year risk SCD score <6%. In this multicenter study, we performed cardiac magnetic resonance in 354 consecutive hypertrophic cardiomyopathy patients (257 males, range of age 54 ± 17) with a risk SCD score <6% (302 with <4% and 52 with ≥4 and <6% risk). Hard cardiac events, including SCD, resuscitated cardiac arrest, appropriate implantable cardioverter defibrillator interventions, sustained ventricular tachycardia, occurred in 22 patients. LGE was detected in a high proportion (92%) of patients with hard cardiac events (p = 0.002). At receiver-operating characteristic curve analysis, LGE extent ≥10% was the best threshold to predict major arrhythmic events (area under the curve: 0.74). Kaplan-Meier curves showed that patients with LGE ≥10% had a worse prognosis than those with lower extent (p < 0.0001). LGE extent was the best independent predictor of hard cardiac events (hazard ratio 1.05; 95% confidence interval [CI] 1.03 to 107; p < 0.0001). The estimates 5-year risk of hard cardiac event was 2.5% (95% CI 0.8 to 4.2) in patients with LGE extent <10% and 23.4% (95% CI 10.2 to 36.5) for those with LGE extent ≥10%. In conclusion, this study demonstrates as the extent of LGE ≥10% is able to recognize additional patients at increased risk for malignant arrhythmic episodes in a population with low-to-intermediate ESC SCD risk score.]]></description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2019.07.023</identifier><identifier>PMID: 31447011</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Cardiac arrhythmia ; Cardiology ; Cardiomyopathy ; Cardiomyopathy, Hypertrophic - complications ; Cardiomyopathy, Hypertrophic - diagnosis ; Cardiomyopathy, Hypertrophic - physiopathology ; Confidence intervals ; Contrast Media - pharmacology ; Death, Sudden, Cardiac - epidemiology ; Death, Sudden, Cardiac - etiology ; Defibrillators ; Diuretics ; Electrocardiography ; Female ; Follow-Up Studies ; Gadolinium ; Gadolinium - pharmacology ; Heart ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - physiopathology ; Humans ; Hypertension ; Implantation ; Incidence ; Investigations ; Italy - epidemiology ; Magnetic resonance ; Magnetic Resonance Imaging, Cine - methods ; Male ; Males ; Medical prognosis ; Middle Aged ; Myocardium - pathology ; Population ; Prognosis ; Questionnaires ; Retrospective Studies ; Risk ; Risk Assessment - methods ; Risk Factors ; ROC Curve ; Survival Rate - trends ; Tachycardia ; Variance analysis ; Ventricle ; Ventricular Function, Left - physiology</subject><ispartof>The American journal of cardiology, 2019-10, Vol.124 (8), p.1286-1292</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><rights>2019. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-d0190cab4d41a654d5c7390bfd525870cb50bc9a763d7a131e7750cde73946043</citedby><cites>FETCH-LOGICAL-c440t-d0190cab4d41a654d5c7390bfd525870cb50bc9a763d7a131e7750cde73946043</cites><orcidid>0000-0003-1637-574X ; 0000-0001-9785-3402</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914919308239$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31447011$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Todiere, Giancarlo</creatorcontrib><creatorcontrib>Nugara, Cinzia</creatorcontrib><creatorcontrib>Gentile, Giovanni</creatorcontrib><creatorcontrib>Negri, Francesco</creatorcontrib><creatorcontrib>Bianco, Francesco</creatorcontrib><creatorcontrib>Falletta, Calogero</creatorcontrib><creatorcontrib>Novo, Giuseppina</creatorcontrib><creatorcontrib>Di Bella, Gianluca</creatorcontrib><creatorcontrib>De Caterina, Raffaele</creatorcontrib><creatorcontrib>Zachara, Elisabetta</creatorcontrib><creatorcontrib>Re, Federica</creatorcontrib><creatorcontrib>Clemenza, Francesco</creatorcontrib><creatorcontrib>Sinagra, Gianfranco</creatorcontrib><creatorcontrib>Emdin, Michele</creatorcontrib><creatorcontrib>Aquaro, Giovanni Donato</creatorcontrib><title>Prognostic Role of Late Gadolinium Enhancement in Patients With Hypertrophic Cardiomyopathy and Low-to-Intermediate Sudden Cardiac Death Risk Score</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description><![CDATA[Sudden cardiac death (SCD) is the most life-threating complication of hypertrophic cardiomyopathy. Guidelines of the European Society of Cardiology (ESC) suggest the implantation of an implantable cardioverter defibrillator in primary prevention according to a 5-year risk SCD score ≥6%. The aim of the study is to evaluate the prognostic role of late gadolinium enhancement (LGE) in patients with a 5-year risk SCD score <6%. In this multicenter study, we performed cardiac magnetic resonance in 354 consecutive hypertrophic cardiomyopathy patients (257 males, range of age 54 ± 17) with a risk SCD score <6% (302 with <4% and 52 with ≥4 and <6% risk). Hard cardiac events, including SCD, resuscitated cardiac arrest, appropriate implantable cardioverter defibrillator interventions, sustained ventricular tachycardia, occurred in 22 patients. LGE was detected in a high proportion (92%) of patients with hard cardiac events (p = 0.002). At receiver-operating characteristic curve analysis, LGE extent ≥10% was the best threshold to predict major arrhythmic events (area under the curve: 0.74). Kaplan-Meier curves showed that patients with LGE ≥10% had a worse prognosis than those with lower extent (p < 0.0001). LGE extent was the best independent predictor of hard cardiac events (hazard ratio 1.05; 95% confidence interval [CI] 1.03 to 107; p < 0.0001). The estimates 5-year risk of hard cardiac event was 2.5% (95% CI 0.8 to 4.2) in patients with LGE extent <10% and 23.4% (95% CI 10.2 to 36.5) for those with LGE extent ≥10%. In conclusion, this study demonstrates as the extent of LGE ≥10% is able to recognize additional patients at increased risk for malignant arrhythmic episodes in a population with low-to-intermediate ESC SCD risk score.]]></description><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiomyopathy</subject><subject>Cardiomyopathy, Hypertrophic - complications</subject><subject>Cardiomyopathy, Hypertrophic - diagnosis</subject><subject>Cardiomyopathy, Hypertrophic - physiopathology</subject><subject>Confidence intervals</subject><subject>Contrast Media - pharmacology</subject><subject>Death, Sudden, Cardiac - epidemiology</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Defibrillators</subject><subject>Diuretics</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gadolinium</subject><subject>Gadolinium - pharmacology</subject><subject>Heart</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Heart Ventricles - physiopathology</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Implantation</subject><subject>Incidence</subject><subject>Investigations</subject><subject>Italy - epidemiology</subject><subject>Magnetic resonance</subject><subject>Magnetic Resonance Imaging, Cine - methods</subject><subject>Male</subject><subject>Males</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Myocardium - pathology</subject><subject>Population</subject><subject>Prognosis</subject><subject>Questionnaires</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>ROC Curve</subject><subject>Survival Rate - trends</subject><subject>Tachycardia</subject><subject>Variance analysis</subject><subject>Ventricle</subject><subject>Ventricular Function, Left - physiology</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkd-O1CAUh4nRuLOrj6Ah8cabVqC0tFfGjPsvmcTNrsZLQuGMQ22hC1Qzz-ELy2RGL7zxCk7ynR-H8yH0ipKSEtq8G0o1DVoFUzJCu5KIkrDqCVrRVnQF7Wj1FK0IIazoKO_O0HmMQy4prZvn6KyinItcrNCvu-C_OR-T1fjej4D9Fm9UAnytjB-ts8uEL91OOQ0TuIStw3cq2XyN-KtNO3yznyGk4OddTljneayf9n5WabfHyhm88T-L5ItblyBMYOwh-2ExBtyRVhp_hEzjexu_4wftA7xAz7ZqjPDydF6gL1eXn9c3xebT9e36w6bQnJNUmPxvolXPDaeqqbmptag60m9NzepWEN3XpNedEk1lhKIVBSFqog1kijeEVxfo7TF3Dv5xgZjkZKOGcVQO_BIlYy2pq4ZVLKNv_kEHvwSXp8tUx9qWCEYyVR8pHXyMAbZyDnZSYS8pkQdrcpAna_JgTRIhs7Xc9_qUvvR5R3-7_mjKwPsjAHkdPywEGXV2oPM-A-gkjbf_eeI3E0-ryA</recordid><startdate>20191015</startdate><enddate>20191015</enddate><creator>Todiere, Giancarlo</creator><creator>Nugara, Cinzia</creator><creator>Gentile, Giovanni</creator><creator>Negri, Francesco</creator><creator>Bianco, Francesco</creator><creator>Falletta, Calogero</creator><creator>Novo, Giuseppina</creator><creator>Di Bella, Gianluca</creator><creator>De Caterina, Raffaele</creator><creator>Zachara, Elisabetta</creator><creator>Re, Federica</creator><creator>Clemenza, Francesco</creator><creator>Sinagra, Gianfranco</creator><creator>Emdin, Michele</creator><creator>Aquaro, Giovanni Donato</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1637-574X</orcidid><orcidid>https://orcid.org/0000-0001-9785-3402</orcidid></search><sort><creationdate>20191015</creationdate><title>Prognostic Role of Late Gadolinium Enhancement in Patients With Hypertrophic Cardiomyopathy and Low-to-Intermediate Sudden Cardiac Death Risk Score</title><author>Todiere, Giancarlo ; Nugara, Cinzia ; Gentile, Giovanni ; Negri, Francesco ; Bianco, Francesco ; Falletta, Calogero ; Novo, Giuseppina ; Di Bella, Gianluca ; De Caterina, Raffaele ; Zachara, Elisabetta ; Re, Federica ; Clemenza, Francesco ; Sinagra, Gianfranco ; Emdin, Michele ; Aquaro, Giovanni Donato</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-d0190cab4d41a654d5c7390bfd525870cb50bc9a763d7a131e7750cde73946043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Cardiomyopathy</topic><topic>Cardiomyopathy, Hypertrophic - complications</topic><topic>Cardiomyopathy, Hypertrophic - diagnosis</topic><topic>Cardiomyopathy, Hypertrophic - physiopathology</topic><topic>Confidence intervals</topic><topic>Contrast Media - pharmacology</topic><topic>Death, Sudden, Cardiac - epidemiology</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Defibrillators</topic><topic>Diuretics</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gadolinium</topic><topic>Gadolinium - pharmacology</topic><topic>Heart</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Heart Ventricles - physiopathology</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Implantation</topic><topic>Incidence</topic><topic>Investigations</topic><topic>Italy - epidemiology</topic><topic>Magnetic resonance</topic><topic>Magnetic Resonance Imaging, Cine - methods</topic><topic>Male</topic><topic>Males</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Myocardium - 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Guidelines of the European Society of Cardiology (ESC) suggest the implantation of an implantable cardioverter defibrillator in primary prevention according to a 5-year risk SCD score ≥6%. The aim of the study is to evaluate the prognostic role of late gadolinium enhancement (LGE) in patients with a 5-year risk SCD score <6%. In this multicenter study, we performed cardiac magnetic resonance in 354 consecutive hypertrophic cardiomyopathy patients (257 males, range of age 54 ± 17) with a risk SCD score <6% (302 with <4% and 52 with ≥4 and <6% risk). Hard cardiac events, including SCD, resuscitated cardiac arrest, appropriate implantable cardioverter defibrillator interventions, sustained ventricular tachycardia, occurred in 22 patients. LGE was detected in a high proportion (92%) of patients with hard cardiac events (p = 0.002). At receiver-operating characteristic curve analysis, LGE extent ≥10% was the best threshold to predict major arrhythmic events (area under the curve: 0.74). Kaplan-Meier curves showed that patients with LGE ≥10% had a worse prognosis than those with lower extent (p < 0.0001). LGE extent was the best independent predictor of hard cardiac events (hazard ratio 1.05; 95% confidence interval [CI] 1.03 to 107; p < 0.0001). The estimates 5-year risk of hard cardiac event was 2.5% (95% CI 0.8 to 4.2) in patients with LGE extent <10% and 23.4% (95% CI 10.2 to 36.5) for those with LGE extent ≥10%. In conclusion, this study demonstrates as the extent of LGE ≥10% is able to recognize additional patients at increased risk for malignant arrhythmic episodes in a population with low-to-intermediate ESC SCD risk score.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31447011</pmid><doi>10.1016/j.amjcard.2019.07.023</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-1637-574X</orcidid><orcidid>https://orcid.org/0000-0001-9785-3402</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Cardiac arrhythmia Cardiology Cardiomyopathy Cardiomyopathy, Hypertrophic - complications Cardiomyopathy, Hypertrophic - diagnosis Cardiomyopathy, Hypertrophic - physiopathology Confidence intervals Contrast Media - pharmacology Death, Sudden, Cardiac - epidemiology Death, Sudden, Cardiac - etiology Defibrillators Diuretics Electrocardiography Female Follow-Up Studies Gadolinium Gadolinium - pharmacology Heart Heart Ventricles - diagnostic imaging Heart Ventricles - physiopathology Humans Hypertension Implantation Incidence Investigations Italy - epidemiology Magnetic resonance Magnetic Resonance Imaging, Cine - methods Male Males Medical prognosis Middle Aged Myocardium - pathology Population Prognosis Questionnaires Retrospective Studies Risk Risk Assessment - methods Risk Factors ROC Curve Survival Rate - trends Tachycardia Variance analysis Ventricle Ventricular Function, Left - physiology |
| title | Prognostic Role of Late Gadolinium Enhancement in Patients With Hypertrophic Cardiomyopathy and Low-to-Intermediate Sudden Cardiac Death Risk Score |
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