Late gadolinium enhancement and the risk of ventricular arrhythmias and sudden death in NYHA class I patients with non‐ischaemic cardiomyopathy
Aim To compare the risk of ventricular arrhythmias (VA) and sudden death (SD) between New York Heart Association (NYHA) class I and NYHA class II–III patients with non‐ischaemic cardiomyopathy (NICM). Methods and results Observational retrospective cohort study including patients with NICM who under...
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| Veröffentlicht in: | European journal of heart failure 2023-05, Vol.25 (5), p.740-750 |
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| creator | Di Marco, Andrea Brown, Pamela Mateus, Gemma Faga, Valentina Nucifora, Gaetano Claver, Eduard Viedma, Jisela Galvan, Francisco Bradley, Joshua Dallaglio, Paolo D. Frutos, Fernando Miller, Christopher A. Comín‐Colet, Josep Anguera, Ignasi Schmitt, Matthias |
| description | Aim
To compare the risk of ventricular arrhythmias (VA) and sudden death (SD) between New York Heart Association (NYHA) class I and NYHA class II–III patients with non‐ischaemic cardiomyopathy (NICM).
Methods and results
Observational retrospective cohort study including patients with NICM who underwent cardiac magnetic resonance at two hospitals. The primary endpoint included appropriate implantable cardioverter defibrillator (ICD) therapies, sustained ventricular tachycardia, resuscitated cardiac arrest and SD. The secondary endpoint included heart failure (HF) hospitalizations, heart transplant, left ventricular assist device implant or HF death. Overall, 698 patients were included, 33% in NYHA class I. During a median follow‐up of 31 months, the primary endpoint occurred in 57 patients (8%), with no differences between NYHA class I and NYHA class II–III cases (7% vs. 9%, p = 0.62). Late gadolinium enhancement (LGE) was the only independent predictor of the primary outcome both in NYHA class I and NYHA class II–III patients. LGE+ NYHA class I patients had a similar cumulative incidence of the primary endpoint as compared to LGE+ NYHA class II–III (p = 0.92) and a significantly higher risk as compared to LGE– NYHA class II–III cases (p |
| doi_str_mv | 10.1002/ejhf.2793 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2776517531</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2776517531</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3253-ab5e1eea7acc3fc10608e5c3dba30027bd5797493b269227d7d52a7455167d583</originalsourceid><addsrcrecordid>eNp1kc9O3DAQxq2qVaHQAy-AfCyHgP_EcXJECLpUq_bSHjhFE3vSGBJnsRNQbn0EeMU-Sb0s7a2nGc385tPMfIQccXbKGRNneNu1p0JX8g3Z56WuMlbm-duUy7LMqjIXe-RDjLeMcZ3w92RPFrrkgrF98ryGCelPsGPvvJsHir4Db3BAP1Hwlk4d0uDiHR1b-pCKwZm5h0AhhG6ZusFBfOHibC16ahGmjjpPv96szqnpIUZ6TTcwuTQb6aNLXT_637-eXDQd4OAMNRCsG4dlTFi3HJJ3LfQRP77GA_Lj6vL7xSpbf_t8fXG-zowUSmbQKOSIoMEY2RrOClaiMtI2INORurFKVzqvZCOKSghttVUCdK4UL1JaygPyaae7CeP9jHGqh7QS9j14HOdYC60LxbWSPKEnO9SEMcaAbb0JboCw1JzVWwfqrQP11oHEHr_Kzs2A9h_59-UJONsBj67H5f9K9eWX1dWL5B_oEJOS</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2776517531</pqid></control><display><type>article</type><title>Late gadolinium enhancement and the risk of ventricular arrhythmias and sudden death in NYHA class I patients with non‐ischaemic cardiomyopathy</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><source>Wiley Online Library Free Content</source><source>EZB Electronic Journals Library</source><creator>Di Marco, Andrea ; Brown, Pamela ; Mateus, Gemma ; Faga, Valentina ; Nucifora, Gaetano ; Claver, Eduard ; Viedma, Jisela ; Galvan, Francisco ; Bradley, Joshua ; Dallaglio, Paolo D. ; Frutos, Fernando ; Miller, Christopher A. ; Comín‐Colet, Josep ; Anguera, Ignasi ; Schmitt, Matthias</creator><creatorcontrib>Di Marco, Andrea ; Brown, Pamela ; Mateus, Gemma ; Faga, Valentina ; Nucifora, Gaetano ; Claver, Eduard ; Viedma, Jisela ; Galvan, Francisco ; Bradley, Joshua ; Dallaglio, Paolo D. ; Frutos, Fernando ; Miller, Christopher A. ; Comín‐Colet, Josep ; Anguera, Ignasi ; Schmitt, Matthias</creatorcontrib><description>Aim
To compare the risk of ventricular arrhythmias (VA) and sudden death (SD) between New York Heart Association (NYHA) class I and NYHA class II–III patients with non‐ischaemic cardiomyopathy (NICM).
Methods and results
Observational retrospective cohort study including patients with NICM who underwent cardiac magnetic resonance at two hospitals. The primary endpoint included appropriate implantable cardioverter defibrillator (ICD) therapies, sustained ventricular tachycardia, resuscitated cardiac arrest and SD. The secondary endpoint included heart failure (HF) hospitalizations, heart transplant, left ventricular assist device implant or HF death. Overall, 698 patients were included, 33% in NYHA class I. During a median follow‐up of 31 months, the primary endpoint occurred in 57 patients (8%), with no differences between NYHA class I and NYHA class II–III cases (7% vs. 9%, p = 0.62). Late gadolinium enhancement (LGE) was the only independent predictor of the primary outcome both in NYHA class I and NYHA class II–III patients. LGE+ NYHA class I patients had a similar cumulative incidence of the primary endpoint as compared to LGE+ NYHA class II–III (p = 0.92) and a significantly higher risk as compared to LGE– NYHA class II–III cases (p < 0.001). The risk of the secondary endpoint was significantly higher in patients in NYHA class II–III as compared to those in NYHA class I (hazard ratio 3.2, p = 0.001).
Conclusions
Patients with NICM in NYHA class I are not necessarily at low risk of VA and SD. Actually, LGE+ NYHA class I patients have a high risk. NYHA class I patients with high‐risk factors, such as LGE, could benefit from primary prevention ICD at least as much as those in NYHA class II–III with the same risk factors.
Risk of ventricular arrhythmias and sudden death in non‐ischaemic cardiomyopathy (NICM) patients: comparison of New York Heart Association (NYHA) I vs NYHA II–III cases and analysis of interaction with late gadolinium enhancement (LGE).</description><identifier>ISSN: 1388-9842</identifier><identifier>EISSN: 1879-0844</identifier><identifier>DOI: 10.1002/ejhf.2793</identifier><identifier>PMID: 36781200</identifier><language>eng</language><publisher>Oxford, UK: John Wiley & Sons, Ltd</publisher><subject>Arrhythmias, Cardiac - epidemiology ; Arrhythmias, Cardiac - etiology ; Arrhythmias, Cardiac - therapy ; Cardiac magnetic resonance ; Cardiomyopathies ; Contrast Media ; Death, Sudden, Cardiac - epidemiology ; Death, Sudden, Cardiac - etiology ; Death, Sudden, Cardiac - prevention & control ; Defibrillators, Implantable - adverse effects ; Gadolinium ; Heart Failure - therapy ; Humans ; Late gadolinium enhancement ; Myocardial Ischemia - complications ; Myocardial Ischemia - diagnostic imaging ; Myocardial Ischemia - epidemiology ; Non‐ischaemic cardiomyopathy ; NYHA class ; Retrospective Studies ; Risk Factors ; Sudden death ; Ventricular arrhythmias</subject><ispartof>European journal of heart failure, 2023-05, Vol.25 (5), p.740-750</ispartof><rights>2023 European Society of Cardiology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3253-ab5e1eea7acc3fc10608e5c3dba30027bd5797493b269227d7d52a7455167d583</citedby><cites>FETCH-LOGICAL-c3253-ab5e1eea7acc3fc10608e5c3dba30027bd5797493b269227d7d52a7455167d583</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fejhf.2793$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fejhf.2793$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36781200$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Di Marco, Andrea</creatorcontrib><creatorcontrib>Brown, Pamela</creatorcontrib><creatorcontrib>Mateus, Gemma</creatorcontrib><creatorcontrib>Faga, Valentina</creatorcontrib><creatorcontrib>Nucifora, Gaetano</creatorcontrib><creatorcontrib>Claver, Eduard</creatorcontrib><creatorcontrib>Viedma, Jisela</creatorcontrib><creatorcontrib>Galvan, Francisco</creatorcontrib><creatorcontrib>Bradley, Joshua</creatorcontrib><creatorcontrib>Dallaglio, Paolo D.</creatorcontrib><creatorcontrib>Frutos, Fernando</creatorcontrib><creatorcontrib>Miller, Christopher A.</creatorcontrib><creatorcontrib>Comín‐Colet, Josep</creatorcontrib><creatorcontrib>Anguera, Ignasi</creatorcontrib><creatorcontrib>Schmitt, Matthias</creatorcontrib><title>Late gadolinium enhancement and the risk of ventricular arrhythmias and sudden death in NYHA class I patients with non‐ischaemic cardiomyopathy</title><title>European journal of heart failure</title><addtitle>Eur J Heart Fail</addtitle><description>Aim
To compare the risk of ventricular arrhythmias (VA) and sudden death (SD) between New York Heart Association (NYHA) class I and NYHA class II–III patients with non‐ischaemic cardiomyopathy (NICM).
Methods and results
Observational retrospective cohort study including patients with NICM who underwent cardiac magnetic resonance at two hospitals. The primary endpoint included appropriate implantable cardioverter defibrillator (ICD) therapies, sustained ventricular tachycardia, resuscitated cardiac arrest and SD. The secondary endpoint included heart failure (HF) hospitalizations, heart transplant, left ventricular assist device implant or HF death. Overall, 698 patients were included, 33% in NYHA class I. During a median follow‐up of 31 months, the primary endpoint occurred in 57 patients (8%), with no differences between NYHA class I and NYHA class II–III cases (7% vs. 9%, p = 0.62). Late gadolinium enhancement (LGE) was the only independent predictor of the primary outcome both in NYHA class I and NYHA class II–III patients. LGE+ NYHA class I patients had a similar cumulative incidence of the primary endpoint as compared to LGE+ NYHA class II–III (p = 0.92) and a significantly higher risk as compared to LGE– NYHA class II–III cases (p < 0.001). The risk of the secondary endpoint was significantly higher in patients in NYHA class II–III as compared to those in NYHA class I (hazard ratio 3.2, p = 0.001).
Conclusions
Patients with NICM in NYHA class I are not necessarily at low risk of VA and SD. Actually, LGE+ NYHA class I patients have a high risk. NYHA class I patients with high‐risk factors, such as LGE, could benefit from primary prevention ICD at least as much as those in NYHA class II–III with the same risk factors.
Risk of ventricular arrhythmias and sudden death in non‐ischaemic cardiomyopathy (NICM) patients: comparison of New York Heart Association (NYHA) I vs NYHA II–III cases and analysis of interaction with late gadolinium enhancement (LGE).</description><subject>Arrhythmias, Cardiac - epidemiology</subject><subject>Arrhythmias, Cardiac - etiology</subject><subject>Arrhythmias, Cardiac - therapy</subject><subject>Cardiac magnetic resonance</subject><subject>Cardiomyopathies</subject><subject>Contrast Media</subject><subject>Death, Sudden, Cardiac - epidemiology</subject><subject>Death, Sudden, Cardiac - etiology</subject><subject>Death, Sudden, Cardiac - prevention & control</subject><subject>Defibrillators, Implantable - adverse effects</subject><subject>Gadolinium</subject><subject>Heart Failure - therapy</subject><subject>Humans</subject><subject>Late gadolinium enhancement</subject><subject>Myocardial Ischemia - complications</subject><subject>Myocardial Ischemia - diagnostic imaging</subject><subject>Myocardial Ischemia - epidemiology</subject><subject>Non‐ischaemic cardiomyopathy</subject><subject>NYHA class</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sudden death</subject><subject>Ventricular arrhythmias</subject><issn>1388-9842</issn><issn>1879-0844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9O3DAQxq2qVaHQAy-AfCyHgP_EcXJECLpUq_bSHjhFE3vSGBJnsRNQbn0EeMU-Sb0s7a2nGc385tPMfIQccXbKGRNneNu1p0JX8g3Z56WuMlbm-duUy7LMqjIXe-RDjLeMcZ3w92RPFrrkgrF98ryGCelPsGPvvJsHir4Db3BAP1Hwlk4d0uDiHR1b-pCKwZm5h0AhhG6ZusFBfOHibC16ahGmjjpPv96szqnpIUZ6TTcwuTQb6aNLXT_637-eXDQd4OAMNRCsG4dlTFi3HJJ3LfQRP77GA_Lj6vL7xSpbf_t8fXG-zowUSmbQKOSIoMEY2RrOClaiMtI2INORurFKVzqvZCOKSghttVUCdK4UL1JaygPyaae7CeP9jHGqh7QS9j14HOdYC60LxbWSPKEnO9SEMcaAbb0JboCw1JzVWwfqrQP11oHEHr_Kzs2A9h_59-UJONsBj67H5f9K9eWX1dWL5B_oEJOS</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Di Marco, Andrea</creator><creator>Brown, Pamela</creator><creator>Mateus, Gemma</creator><creator>Faga, Valentina</creator><creator>Nucifora, Gaetano</creator><creator>Claver, Eduard</creator><creator>Viedma, Jisela</creator><creator>Galvan, Francisco</creator><creator>Bradley, Joshua</creator><creator>Dallaglio, Paolo D.</creator><creator>Frutos, Fernando</creator><creator>Miller, Christopher A.</creator><creator>Comín‐Colet, Josep</creator><creator>Anguera, Ignasi</creator><creator>Schmitt, Matthias</creator><general>John Wiley & Sons, Ltd</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>7X8</scope></search><sort><creationdate>202305</creationdate><title>Late gadolinium enhancement and the risk of ventricular arrhythmias and sudden death in NYHA class I patients with non‐ischaemic cardiomyopathy</title><author>Di Marco, Andrea ; Brown, Pamela ; Mateus, Gemma ; Faga, Valentina ; Nucifora, Gaetano ; Claver, Eduard ; Viedma, Jisela ; Galvan, Francisco ; Bradley, Joshua ; Dallaglio, Paolo D. ; Frutos, Fernando ; Miller, Christopher A. ; Comín‐Colet, Josep ; Anguera, Ignasi ; Schmitt, Matthias</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3253-ab5e1eea7acc3fc10608e5c3dba30027bd5797493b269227d7d52a7455167d583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Arrhythmias, Cardiac - epidemiology</topic><topic>Arrhythmias, Cardiac - etiology</topic><topic>Arrhythmias, Cardiac - therapy</topic><topic>Cardiac magnetic resonance</topic><topic>Cardiomyopathies</topic><topic>Contrast Media</topic><topic>Death, Sudden, Cardiac - epidemiology</topic><topic>Death, Sudden, Cardiac - etiology</topic><topic>Death, Sudden, Cardiac - prevention & control</topic><topic>Defibrillators, Implantable - adverse effects</topic><topic>Gadolinium</topic><topic>Heart Failure - therapy</topic><topic>Humans</topic><topic>Late gadolinium enhancement</topic><topic>Myocardial Ischemia - complications</topic><topic>Myocardial Ischemia - diagnostic imaging</topic><topic>Myocardial Ischemia - epidemiology</topic><topic>Non‐ischaemic cardiomyopathy</topic><topic>NYHA class</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sudden death</topic><topic>Ventricular arrhythmias</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Di Marco, Andrea</creatorcontrib><creatorcontrib>Brown, Pamela</creatorcontrib><creatorcontrib>Mateus, Gemma</creatorcontrib><creatorcontrib>Faga, Valentina</creatorcontrib><creatorcontrib>Nucifora, Gaetano</creatorcontrib><creatorcontrib>Claver, Eduard</creatorcontrib><creatorcontrib>Viedma, Jisela</creatorcontrib><creatorcontrib>Galvan, Francisco</creatorcontrib><creatorcontrib>Bradley, Joshua</creatorcontrib><creatorcontrib>Dallaglio, Paolo D.</creatorcontrib><creatorcontrib>Frutos, Fernando</creatorcontrib><creatorcontrib>Miller, Christopher A.</creatorcontrib><creatorcontrib>Comín‐Colet, Josep</creatorcontrib><creatorcontrib>Anguera, Ignasi</creatorcontrib><creatorcontrib>Schmitt, Matthias</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Di Marco, Andrea</au><au>Brown, Pamela</au><au>Mateus, Gemma</au><au>Faga, Valentina</au><au>Nucifora, Gaetano</au><au>Claver, Eduard</au><au>Viedma, Jisela</au><au>Galvan, Francisco</au><au>Bradley, Joshua</au><au>Dallaglio, Paolo D.</au><au>Frutos, Fernando</au><au>Miller, Christopher A.</au><au>Comín‐Colet, Josep</au><au>Anguera, Ignasi</au><au>Schmitt, Matthias</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Late gadolinium enhancement and the risk of ventricular arrhythmias and sudden death in NYHA class I patients with non‐ischaemic cardiomyopathy</atitle><jtitle>European journal of heart failure</jtitle><addtitle>Eur J Heart Fail</addtitle><date>2023-05</date><risdate>2023</risdate><volume>25</volume><issue>5</issue><spage>740</spage><epage>750</epage><pages>740-750</pages><issn>1388-9842</issn><eissn>1879-0844</eissn><abstract>Aim
To compare the risk of ventricular arrhythmias (VA) and sudden death (SD) between New York Heart Association (NYHA) class I and NYHA class II–III patients with non‐ischaemic cardiomyopathy (NICM).
Methods and results
Observational retrospective cohort study including patients with NICM who underwent cardiac magnetic resonance at two hospitals. The primary endpoint included appropriate implantable cardioverter defibrillator (ICD) therapies, sustained ventricular tachycardia, resuscitated cardiac arrest and SD. The secondary endpoint included heart failure (HF) hospitalizations, heart transplant, left ventricular assist device implant or HF death. Overall, 698 patients were included, 33% in NYHA class I. During a median follow‐up of 31 months, the primary endpoint occurred in 57 patients (8%), with no differences between NYHA class I and NYHA class II–III cases (7% vs. 9%, p = 0.62). Late gadolinium enhancement (LGE) was the only independent predictor of the primary outcome both in NYHA class I and NYHA class II–III patients. LGE+ NYHA class I patients had a similar cumulative incidence of the primary endpoint as compared to LGE+ NYHA class II–III (p = 0.92) and a significantly higher risk as compared to LGE– NYHA class II–III cases (p < 0.001). The risk of the secondary endpoint was significantly higher in patients in NYHA class II–III as compared to those in NYHA class I (hazard ratio 3.2, p = 0.001).
Conclusions
Patients with NICM in NYHA class I are not necessarily at low risk of VA and SD. Actually, LGE+ NYHA class I patients have a high risk. NYHA class I patients with high‐risk factors, such as LGE, could benefit from primary prevention ICD at least as much as those in NYHA class II–III with the same risk factors.
Risk of ventricular arrhythmias and sudden death in non‐ischaemic cardiomyopathy (NICM) patients: comparison of New York Heart Association (NYHA) I vs NYHA II–III cases and analysis of interaction with late gadolinium enhancement (LGE).</abstract><cop>Oxford, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>36781200</pmid><doi>10.1002/ejhf.2793</doi><tpages>11</tpages></addata></record> |
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| subjects | Arrhythmias, Cardiac - epidemiology Arrhythmias, Cardiac - etiology Arrhythmias, Cardiac - therapy Cardiac magnetic resonance Cardiomyopathies Contrast Media Death, Sudden, Cardiac - epidemiology Death, Sudden, Cardiac - etiology Death, Sudden, Cardiac - prevention & control Defibrillators, Implantable - adverse effects Gadolinium Heart Failure - therapy Humans Late gadolinium enhancement Myocardial Ischemia - complications Myocardial Ischemia - diagnostic imaging Myocardial Ischemia - epidemiology Non‐ischaemic cardiomyopathy NYHA class Retrospective Studies Risk Factors Sudden death Ventricular arrhythmias |
| title | Late gadolinium enhancement and the risk of ventricular arrhythmias and sudden death in NYHA class I patients with non‐ischaemic cardiomyopathy |
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