PMID- 24813968
OWN - NLM
STAT- MEDLINE
DCOM- 20150204
LR  - 20220129
IS  - 1876-7591 (Electronic)
IS  - 1876-7591 (Linking)
VI  - 7
IP  - 6
DP  - 2014 Jun
TI  - LGE and NT-proBNP identify low risk of death or arrhythmic events in patients 
      with primary prevention ICDs.
PG  - 561-9
LID - S1936-878X(14)00237-X [pii]
LID - 10.1016/j.jcmg.2013.12.014 [doi]
AB  - OBJECTIVES: The aim of this study was to investigate whether late gadolinium 
      enhancement (LGE) magnetic resonance imaging or N-terminal pro-B-type natriuretic 
      peptide (NT-proBNP) could identify patients with a low risk of death or use of 
      implantable cardioverter-defibrillator (ICD) in patients receiving a primary 
      prevention ICD. BACKGROUND: ICDs reduce mortality in patients with heart failure 
      (HF), although two-thirds may never use their device. Current risk 
      stratification, based on New York Heart Association functional class and left 
      ventricular ejection fraction, still leads to implantation of ICDs in patients 
      who may never need their device. METHODS: We examined 157 patients with HF (61 
      with ischemic cardiomyopathy and 96 with dilated cardiomyopathy; mean age 50.5 
      years; 78% male) who underwent primary prevention defibrillator implantation. 
      Presence and volume of LGE was measured before device implantation, and serum 
      NT-proBNP level was measured before ICD implantation. The combined primary 
      endpoint was cardiovascular death or appropriate ICD therapy (either appropriate 
      shock or antitachycardia pacing). RESULTS: The primary outcome occurred in 32 
      patients (20.4%) over a median follow-up period of 915 days. Percentage of LGE 
      (hazard ratio [HR]: per 1% increase: 1.06; 95% confidence interval [CI]: 1.04 to 
      1.09; p < 0.001) and (ln) NT-proBNP (HR: 1.44; 95% CI: 1.04 to 1.98; p = 0.027) 
      were predictors of death or appropriate ICD activation and remained significant 
      when entered into multivariable analysis. When the cohort was stratified into 
      tertiles based on LGE percentage and NT-proBNP, we were able to identify a 
      low-risk group (event rate 3% per year, compared with the intermediate- and 
      high-risk groups [6% and 10% per year, respectively]). CONCLUSIONS: Both 
      percentage of LGE and NT-proBNP were associated with higher risk of death or 
      appropriate ICD activation. The use of these markers in combination may be useful 
      in identifying individuals most likely to benefit from this costly intervention, 
      and more specifically, in the identification of a group at lower risk in whom ICD 
      implantation may be deferred.
CI  - Copyright (c) 2014 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Mordi, Ify
AU  - Mordi I
AD  - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of 
      Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United 
      Kingdom.
FAU - Jhund, Pardeep S
AU  - Jhund PS
AD  - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of 
      Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United 
      Kingdom.
FAU - Gardner, Roy S
AU  - Gardner RS
AD  - Golden Jubilee National Hospital, Clydebank, United Kingdom.
FAU - Payne, John
AU  - Payne J
AD  - Golden Jubilee National Hospital, Clydebank, United Kingdom.
FAU - Carrick, David
AU  - Carrick D
AD  - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of 
      Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United 
      Kingdom.
FAU - Berry, Colin
AU  - Berry C
AD  - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of 
      Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United 
      Kingdom; Golden Jubilee National Hospital, Clydebank, United Kingdom.
FAU - Tzemos, Nikolaos
AU  - Tzemos N
AD  - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of 
      Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United 
      Kingdom; Golden Jubilee National Hospital, Clydebank, United Kingdom. Electronic 
      address: niko.tzemos@glasgow.ac.uk.
LA  - eng
GR  - PG/11/2/28474/BHF_/British Heart Foundation/United Kingdom
GR  - SCD/01/CSO_/Chief Scientist Office/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140507
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Defibrillators, Implantable
MH  - Female
MH  - *Gadolinium
MH  - Heart Failure/mortality/*therapy
MH  - Humans
MH  - Image Enhancement
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Peptide Fragments/*blood
MH  - Primary Prevention
MH  - Risk Assessment
OTO - NOTNLM
OT  - MRI
OT  - death
OT  - implantable cardioverter-defibrillator (ICD)
OT  - natriuretic peptides
EDAT- 2014/05/13 06:00
MHDA- 2015/02/05 06:00
CRDT- 2014/05/13 06:00
PHST- 2013/11/11 00:00 [received]
PHST- 2013/12/18 00:00 [revised]
PHST- 2013/12/26 00:00 [accepted]
PHST- 2014/05/13 06:00 [entrez]
PHST- 2014/05/13 06:00 [pubmed]
PHST- 2015/02/05 06:00 [medline]
AID - S1936-878X(14)00237-X [pii]
AID - 10.1016/j.jcmg.2013.12.014 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2014 Jun;7(6):561-9. doi: 10.1016/j.jcmg.2013.12.014. 
      Epub 2014 May 7.