| Title: |
Arrhythmic Risk Stratification by Cardiovascular Magnetic Resonance Imaging in Patients With Nonischemic Cardiomyopathy |
| Authors: |
Hammersley, DJ; Zegard, A; Androulakis, E; Jones, RE; Okafor, O; Hatipoglu, S; Mach, L; Lota, AS; Khalique, Z; de Marvao, A; Gulati, A; Baruah, R; Guha, K; Ware, JS; Tayal, U; Pennell, DJ; Halliday, BP; Qiu, T; Prasad, SK; Leyva, F |
| Publisher Information: |
Elsevier BV |
| Publication Year: |
2024 |
| Collection: |
St George's University of London: Repository |
| Description: |
BACKGROUND: Myocardial fibrosis (MF) forms part of the arrhythmic substrate for ventricular arrhythmias (VAs). OBJECTIVES: This study sought to determine whether total myocardial fibrosis (TF) and gray zone fibrosis (GZF), assessed using cardiovascular magnetic resonance, are better than left ventricular ejection fraction (LVEF) in predicting ventricular arrhythmias in patients with nonischemic cardiomyopathy (NICM). METHODS: Patients with NICM in a derivation cohort (n = 866) and a validation cohort (n = 848) underwent quantification of TF and GZF. The primary composite endpoint was sudden cardiac death or VAs (ventricular fibrillation or ventricular tachycardia). RESULTS: The primary endpoint was met by 52 of 866 (6.0%) patients in the derivation cohort (median follow-up: 7.5 years; Q1-Q3: 5.2-9.3 years). In competing-risks analyses, MF on visual assessment (MFVA) predicted the primary endpoint (HR: 5.83; 95% CI: 3.15-10.8). Quantified MF measures permitted categorization into 3 risk groups: a TF of >0 g and ≤10 g was associated with an intermediate risk (HR: 4.03; 95% CI: 1.99-8.16), and a TF of >10 g was associated with the highest risk (HR: 9.17; 95% CI: 4.64-18.1) compared to patients with no MFVA (lowest risk). Similar trends were observed in the validation cohort. Categorization into these 3 risk groups was achievable using TF or GZF in combination or in isolation. In contrast, LVEF of |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
0735-1097 |
| Relation: |
https://openaccess.sgul.ac.uk/id/eprint/118446/2/1-s2.0-S0735109724081099-main.pdf; https://openaccess.sgul.ac.uk/id/eprint/118446/1/1-s2.0-S0735109724081099-mmc1.pdf; Hammersley, DJ; Zegard, A; Androulakis, E; Jones, RE; Okafor, O; Hatipoglu, S; Mach, L; Lota, AS; Khalique, Z; de Marvao, A; et al. Hammersley, DJ; Zegard, A; Androulakis, E; Jones, RE; Okafor, O; Hatipoglu, S; Mach, L; Lota, AS; Khalique, Z; de Marvao, A; Gulati, A; Baruah, R; Guha, K; Ware, JS; Tayal, U; Pennell, DJ; Halliday, BP; Qiu, T; Prasad, SK; Leyva, F (2024) Arrhythmic Risk Stratification by Cardiovascular Magnetic Resonance Imaging in Patients With Nonischemic Cardiomyopathy. Journal of the American College of Cardiology, 84 (15). pp. 1407-1420. ISSN 0735-1097 https://doi.org/10.1016/j.jacc.2024.06.046 SGUL Authors: Androulakis, Emmanouil |
| DOI: |
10.1016/j.jacc.2024.06.046 |
| Availability: |
https://openaccess.sgul.ac.uk/id/eprint/118446/; https://doi.org/10.1016/j.jacc.2024.06.046 |
| Rights: |
cc_by_4 |
| Accession Number: |
edsbas.9296C961 |
| Database: |
BASE |