PMID- 25797123
OWN - NLM
STAT- MEDLINE
DCOM- 20160111
LR  - 20240213
IS  - 1876-7591 (Electronic)
IS  - 1936-878X (Print)
IS  - 1876-7591 (Linking)
VI  - 8
IP  - 4
DP  - 2015 Apr
TI  - Late gadolinium enhancement among survivors of sudden cardiac arrest.
PG  - 414-423
LID - S1936-878X(15)00090-X [pii]
LID - 10.1016/j.jcmg.2014.11.017 [doi]
AB  - OBJECTIVES: The aim of this study was to describe the role of contrast-enhanced 
      cardiac magnetic resonance (CMR) in the workup of patients with aborted sudden 
      cardiac arrest (SCA) and in the prediction of long-term outcomes. BACKGROUND: 
      Myocardial fibrosis is a key substrate for SCA, and late gadolinium enhancement 
      (LGE) on a CMR study is a robust technique for imaging of myocardial fibrosis. 
      METHODS: We performed a retrospective review of all survivors of SCA who were 
      referred for CMR studies and performed follow-up for the subsequent occurrence of 
      an adverse event (death and appropriate defibrillator therapy). RESULTS: After a 
      workup that included a clinical history, electrocardiogram, echocardiography, and 
      coronary angiogram, 137 patients underwent CMR for workup of aborted SCA (66% 
      male; mean age 56 +/- 11 years; left ventricular ejection fraction 43 +/- 12%). The 
      presenting arrhythmias were ventricular fibrillation (n = 105 [77%]) and 
      ventricular tachycardia (n = 32 [23%]). Overall, LGE was found in 98 patients 
      (71%), with an average extent of 9.9 +/- 5% of the left ventricular myocardium. CMR 
      imaging provided a diagnosis or an arrhythmic substrate in 104 patients (76%), 
      including the presence of an infarct-pattern LGE in 60 patients (44%), noninfarct 
      LGE in 21 (15%), active myocarditis in 14 (10%), hypertrophic cardiomyopathy in 3 
      (2%), sarcoidosis in 3, and arrhythmogenic cardiomyopathy in 3. In a median 
      follow-up of 29 months (range 18 to 43 months), there were 63 events. In a 
      multivariable analysis, the strongest predictors of recurrent events were the 
      presence of LGE (adjusted hazard ratio: 6.7; 95% CI: 2.38 to 18.85; p < 0.001) 
      and the extent of LGE (hazard ratio: 1.15; 95% CI: 1.11 to 1.19; p < 0.001). 
      CONCLUSIONS: Among patients with SCA, CMR with contrast identified LGE in 71% and 
      provided a potential arrhythmic substrate in 76%. In follow-up, both the presence 
      and extent of LGE identified a group at markedly increased risk of future adverse 
      events.
CI  - Copyright (c) 2015 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Neilan, Tomas G
AU  - Neilan TG
AD  - Division of Cardiology, Department of Medicine, Massachusetts General Hospital, 
      Boston, Massachusetts; Cardiac MR PET CT Program, Department of Radiology, 
      Massachusetts General Hospital, Boston, Massachusetts.
FAU - Farhad, Hoshang
AU  - Farhad H
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts.
FAU - Mayrhofer, Thomas
AU  - Mayrhofer T
AD  - Cardiac MR PET CT Program, Department of Radiology, Massachusetts General 
      Hospital, Boston, Massachusetts.
FAU - Shah, Ravi V
AU  - Shah RV
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts.
FAU - Dodson, John A
AU  - Dodson JA
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts.
FAU - Abbasi, Siddique A
AU  - Abbasi SA
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts.
FAU - Danik, Stephan B
AU  - Danik SB
AD  - Division of Cardiology, Department of Medicine, Mount Sinai St. Luke's Roosevelt 
      Hospital, New York, New York.
FAU - Verdini, Daniel J
AU  - Verdini DJ
AD  - Cardiac MR PET CT Program, Department of Radiology, Massachusetts General 
      Hospital, Boston, Massachusetts.
FAU - Tokuda, Michifumi
AU  - Tokuda M
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts.
FAU - Tedrow, Usha B
AU  - Tedrow UB
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts.
FAU - Jerosch-Herold, Michael
AU  - Jerosch-Herold M
AD  - Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 
      Boston, Massachusetts.
FAU - Hoffmann, Udo
AU  - Hoffmann U
AD  - Cardiac MR PET CT Program, Department of Radiology, Massachusetts General 
      Hospital, Boston, Massachusetts.
FAU - Ghoshhajra, Brian B
AU  - Ghoshhajra BB
AD  - Cardiac MR PET CT Program, Department of Radiology, Massachusetts General 
      Hospital, Boston, Massachusetts.
FAU - Stevenson, William G
AU  - Stevenson WG
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts.
FAU - Kwong, Raymond Y
AU  - Kwong RY
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts. Electronic address: rykwong@partners.org.
LA  - eng
GR  - T32 HL094301/HL/NHLBI NIH HHS/United States
GR  - R01 HL091157/HL/NHLBI NIH HHS/United States
GR  - R01HL090634-01A1/HL/NHLBI NIH HHS/United States
GR  - UH3 TR000901/TR/NCATS NIH HHS/United States
GR  - R01 HL090634/HL/NHLBI NIH HHS/United States
GR  - R01HL091157/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20150318
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
CIN - JACC Cardiovasc Imaging. 2015 Apr;8(4):424-6. PMID: 25882572
CIN - JACC Cardiovasc Imaging. 2016 Mar;9(3):327. PMID: 26965734
CIN - JACC Cardiovasc Imaging. 2016 Mar;9(3):327-8. PMID: 26965735
MH  - Contrast Media
MH  - Coronary Angiography
MH  - Death, Sudden, Cardiac/*pathology
MH  - Echocardiography
MH  - Electrocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Gadolinium
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Survivors
PMC - PMC4785883
MID - NIHMS764539
OTO - NOTNLM
OT  - cardiac magnetic resonance
OT  - implantable cardioverter-defibrillator
OT  - late gadolinium enhancement
EDAT- 2015/03/24 06:00
MHDA- 2016/01/12 06:00
PMCR- 2016/03/10
CRDT- 2015/03/24 06:00
PHST- 2014/07/11 00:00 [received]
PHST- 2014/11/14 00:00 [revised]
PHST- 2014/11/20 00:00 [accepted]
PHST- 2015/03/24 06:00 [entrez]
PHST- 2015/03/24 06:00 [pubmed]
PHST- 2016/01/12 06:00 [medline]
PHST- 2016/03/10 00:00 [pmc-release]
AID - S1936-878X(15)00090-X [pii]
AID - 10.1016/j.jcmg.2014.11.017 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2015 Apr;8(4):414-423. doi: 10.1016/j.jcmg.2014.11.017. 
      Epub 2015 Mar 18.