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Prognostic Value of Quantitative Contrast-Enhanced Cardiovascular Magnetic Resonance for the Evaluation of Sudden Death Risk in Patients With Hypertrophic Cardiomyopathy

Chan, Raymond H ; Maron, Barry J ; Olivotto, Iacopo ; Pencina, Michael J ; Assenza, Gabriele Egidy ; Haas, Tammy ; Lesser, John R ; Gruner, Christiane ; Crean, Andrew M ; Rakowski, Harry ; Udelson, James E ; Rowin, Ethan ; Lombardi, Massimo ; Cecchi, Franco ; Tomberli, Benedetta ; Spirito, Paolo ; Formisano, Francesco ; Biagini, Elena ; Rapezzi, Claudio ; De Cecco, Carlo Nicola ; Autore, Camillo ; Cook, E Francis ; Hong, Susie N ; Gibson, C Michael ; Manning, Warren J ; Appelbaum, Evan ; Maron, Martin S

Circulation (New York, N.Y.), 2014-08, Vol.130 (6), p.484-495 [Periódico revisado por pares]

Hagerstown, MD: by the American College of Cardiology Foundation and the American Heart Association, Inc

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Título:
Prognostic Value of Quantitative Contrast-Enhanced Cardiovascular Magnetic Resonance for the Evaluation of Sudden Death Risk in Patients With Hypertrophic Cardiomyopathy
Autor: Chan, Raymond H ; Maron, Barry J ; Olivotto, Iacopo ; Pencina, Michael J ; Assenza, Gabriele Egidy ; Haas, Tammy ; Lesser, John R ; Gruner, Christiane ; Crean, Andrew M ; Rakowski, Harry ; Udelson, James E ; Rowin, Ethan ; Lombardi, Massimo ; Cecchi, Franco ; Tomberli, Benedetta ; Spirito, Paolo ; Formisano, Francesco ; Biagini, Elena ; Rapezzi, Claudio ; De Cecco, Carlo Nicola ; Autore, Camillo ; Cook, E Francis ; Hong, Susie N ; Gibson, C Michael ; Manning, Warren J ; Appelbaum, Evan ; Maron, Martin S
Assuntos: Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cardiomyopathy, Hypertrophic - diagnosis ; Cardiomyopathy, Hypertrophic - mortality ; Child ; Cohort Studies ; Contrast Media ; Death, Sudden, Cardiac - epidemiology ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Emergency and intensive care: neonates and children. Prematurity. Sudden death ; Female ; Gadolinium ; Heart ; Humans ; Intensive care medicine ; Magnetic Resonance Imaging, Cine - standards ; Male ; Medical sciences ; Middle Aged ; Myocarditis. Cardiomyopathies ; Prognosis ; Risk Factors ; Single-Blind Method ; Young Adult
É parte de: Circulation (New York, N.Y.), 2014-08, Vol.130 (6), p.484-495
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-News-2
ObjectType-Feature-3
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Descrição: BACKGROUND—Hypertrophic cardiomyopathy (HCM) is the most common cause of sudden death in the young, although not all patients eligible for sudden death prevention with an implantable cardioverter-defibrillator are identified. Contrast-enhanced cardiovascular magnetic resonance with late gadolinium enhancement (LGE) has emerged as an in vivo marker of myocardial fibrosis, although its role in stratifying sudden death risk in subgroups of HCM patients remains incompletely understood. METHODS AND RESULTS—We assessed the relation between LGE and cardiovascular outcomes in 1293 HCM patients referred for cardiovascular magnetic resonance and followed up for a median of 3.3 years. Sudden cardiac death (SCD) events (including appropriate defibrillator interventions) occurred in 37 patients (3%). A continuous relationship was evident between LGE by percent left ventricular mass and SCD event risk in HCM patients (P=0.001). Extent of LGE was associated with an increased risk of SCD events (adjusted hazard ratio, 1.46/10% increase in LGE; P=0.002), even after adjustment for other relevant disease variables. LGE of ≥15% of LV mass demonstrated a 2-fold increase in SCD event risk in those patients otherwise considered to be at lower risk, with an estimated likelihood for SCD events of 6% at 5 years. Performance of the SCD event risk model was enhanced by LGE (net reclassification index, 12.9%; 95% confidence interval, 0.3–38.3). Absence of LGE was associated with lower risk for SCD events (adjusted hazard ratio, 0.39; P=0.02). Extent of LGE also predicted the development of end-stage HCM with systolic dysfunction (adjusted hazard ratio, 1.80/10% increase in LGE; P<0.03). CONCLUSIONS—Extensive LGE measured by quantitative contrast enhanced CMR provides additional information for assessing SCD event risk among HCM patients, particularly patients otherwise judged to be at low risk.
Editor: Hagerstown, MD: by the American College of Cardiology Foundation and the American Heart Association, Inc
Idioma: Inglês

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Prognostic Value of Quantitative Contrast-Enhanced Cardiovascular Magnetic Resonance for the Evaluation of Sudden Death Risk in Patients With Hypertrophic Cardiomyopathy

Hagerstown, MD: by the American College of Cardiology Foundation and the American Heart Association, Inc

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