PMID- 24440822
OWN - NLM
STAT- MEDLINE
DCOM- 20150204
LR  - 20161222
IS  - 1556-3871 (Electronic)
IS  - 1547-5271 (Linking)
VI  - 11
IP  - 5
DP  - 2014 May
TI  - Impact of the presence and amount of myocardial fibrosis by cardiac magnetic 
      resonance on arrhythmic outcome and sudden cardiac death in nonischemic dilated 
      cardiomyopathy.
PG  - 856-63
LID - S1547-5271(14)00037-X [pii]
LID - 10.1016/j.hrthm.2014.01.014 [doi]
AB  - BACKGROUND: Current risk stratification for sudden cardiac death (SCD) in 
      nonischemic dilated cardiomyopathy (NIDC) relies on left ventricular (LV) 
      dysfunction, a poor marker of ventricular electrical instability. 
      Contrast-enhanced cardiac magnetic resonance has the ability to accurately 
      identify and quantify ventricular myocardial fibrosis (late gadolinium 
      enhancement [LGE]). OBJECTIVE: To evaluate the impact of the presence and amount 
      of myocardial fibrosis on arrhythmogenic risk prediction in NIDC. METHODS: One 
      hundred thirty-seven consecutive patients with angiographically proven NIDC were 
      enrolled for this study. All patients were followed up for a combined arrhythmic 
      end point including sustained ventricular tachycardia (VT), appropriate 
      implantable cardioverter-defibrillator (ICD) intervention, ventricular 
      fibrillation (VF), and SCD. RESULTS: LV-LGE was identified in 76 (55.5%) 
      patients. During a median follow-up of 3 years, the combined arrhythmic end point 
      occurred in 22 (16.1%) patients: 8 (5.8%) sustained VT, 9 (6.6%) appropriate ICD 
      intervention, either against VF (n = 5; 3.6%) or VT (n = 4; 2.9%), 3 (2.2%) 
      aborted SCD, and 2 (1.5%) died suddenly. Kaplan-Meier analysis revealed a 
      significant correlation between the LV-LGE presence (not the amount and 
      distribution) and malignant arrhythmic events (P < .001). In univariate Cox 
      regression analysis, LV-LGE (hazard ratio [HR] 4.17; 95% confidence interval [CI] 
      1.56-11.2; P = .005) and left bundle branch block (HR 2.43; 95% CI 1.01-5.41; P = 
      .048) were found to be associated with arrhythmias. In multivariable analysis, 
      the presence of LGE was the only independent predictor of arrhythmias (HR 3.8; 
      95% CI 1.3-10.4; P = .01). CONCLUSIONS: LV-LGE is a powerful and independent 
      predictor of malignant arrhythmic prognosis, while its amount and distribution do 
      not provide additional prognostic value. Contrast-enhanced cardiac magnetic 
      resonance may contribute to identify candidates for ICD therapy not fulfilling 
      the current criteria based on left ventricular ejection fraction.
CI  - Copyright (c) 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights 
      reserved.
FAU - Perazzolo Marra, Martina
AU  - Perazzolo Marra M
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - De Lazzari, Manuel
AU  - De Lazzari M
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - Zorzi, Alessandro
AU  - Zorzi A
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - Migliore, Federico
AU  - Migliore F
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - Zilio, Filippo
AU  - Zilio F
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - Calore, Chiara
AU  - Calore C
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - Vettor, Giulia
AU  - Vettor G
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - Tona, Francesco
AU  - Tona F
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - Tarantini, Giuseppe
AU  - Tarantini G
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - Cacciavillani, Luisa
AU  - Cacciavillani L
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - Corbetti, Francesco
AU  - Corbetti F
AD  - Department of Medical Diagnostic Sciences and Special Therapies; University of 
      Padova, Padova, Italy.
FAU - Giorgi, Benedetta
AU  - Giorgi B
AD  - Department of Medical Diagnostic Sciences and Special Therapies; University of 
      Padova, Padova, Italy.
FAU - Miotto, Diego
AU  - Miotto D
AD  - Department of Medical Diagnostic Sciences and Special Therapies; University of 
      Padova, Padova, Italy.
FAU - Thiene, Gaetano
AU  - Thiene G
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - Basso, Cristina
AU  - Basso C
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - Iliceto, Sabino
AU  - Iliceto S
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy.
FAU - Corrado, Domenico
AU  - Corrado D
AD  - Department of Cardiac, Thoracic and Vascular Sciences; University of Padova, 
      Padova, Italy. Electronic address: domenico.corrado@unipd.it.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140115
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiomyopathy, Dilated/*complications/diagnosis/physiopathology
MH  - Death, Sudden, Cardiac/epidemiology/*etiology
MH  - *Defibrillators, Implantable
MH  - Female
MH  - Fibrosis/complications/diagnosis
MH  - Humans
MH  - Incidence
MH  - Italy/epidemiology
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Risk Factors
MH  - Survival Rate/trends
MH  - Tachycardia, Ventricular/*complications/diagnosis/therapy
MH  - Treatment Outcome
MH  - Ventricular Function, Left/*physiology
OTO - NOTNLM
OT  - Arrhythmias
OT  - Cardiac magnetic resonance
OT  - Dilated cardiomyopathy
OT  - Heart failure
OT  - Late gadolinium enhancement
OT  - Risk stratification
EDAT- 2014/01/21 06:00
MHDA- 2015/02/05 06:00
CRDT- 2014/01/21 06:00
PHST- 2013/09/24 00:00 [received]
PHST- 2014/01/21 06:00 [entrez]
PHST- 2014/01/21 06:00 [pubmed]
PHST- 2015/02/05 06:00 [medline]
AID - S1547-5271(14)00037-X [pii]
AID - 10.1016/j.hrthm.2014.01.014 [doi]
PST - ppublish
SO  - Heart Rhythm. 2014 May;11(5):856-63. doi: 10.1016/j.hrthm.2014.01.014. Epub 2014 
      Jan 15.