PMID- 29550522
OWN - NLM
STAT- MEDLINE
DCOM- 20190116
LR  - 20190116
IS  - 1556-3871 (Electronic)
IS  - 1547-5271 (Linking)
VI  - 15
IP  - 7
DP  - 2018 Jul
TI  - Diagnostic value and prognostic implications of early cardiac magnetic resonance 
      in survivors of out-of-hospital cardiac arrest.
PG  - 1031-1041
LID - S1547-5271(18)30195-4 [pii]
LID - 10.1016/j.hrthm.2018.02.033 [doi]
AB  - BACKGROUND: In patients who survived out-of-hospital cardiac arrest (OHCA), it is 
      crucial to establish the underlying cause and its potential reversibility. 
      OBJECTIVE: The purpose of this study was to assess the incremental diagnostic and 
      prognostic role of early cardiac magnetic resonance (CMR) in survivors of OHCA. 
      METHODS: Among 139 consecutive OHCA patients, the study enrolled 44 patients 
      (median age 43 years; 84% male) who underwent coronary angiography and CMR </=7 
      days after admission. The CMR protocol included T2-weighted sequences for 
      myocardial edema and late gadolinium enhancement (LGE) sequences for myocardial 
      fibrosis. RESULTS: Coronary angiography identified obstructive coronary artery 
      disease in 18 of 44 patients in whom CMR confirmed the diagnosis of ischemic 
      heart disease by demonstrating subendocardial or transmural LGE. The presence of 
      myocardial edema allowed differentiation between acute myocardial ischemia (n = 
      12) and postinfarction myocardial scar (n = 6). Among the remaining 26 patients 
      without obstructive coronary artery disease, CMR in 19 (73%) showed dilated 
      cardiomyopathy in 5, myocarditis in 4, mitral valve prolapse associated with LGE 
      in 3, ischemic scar in 2, idiopathic nonischemic scar in 2, arrhythmogenic 
      cardiomyopathy in 1, hypertrophic cardiomyopathy in 1, and takotsubo 
      cardiomyopathy in 1. In this subgroup of 26 patients, 6 (23%) had myocardial 
      edema. During mean follow-up of 36 +/- 17 months, all 18 patients with myocardial 
      edema had an uneventful outcome, whereas 9 of 26 (35%) without myocardial edema 
      experienced sudden arrhythmic death (n = 1), appropriate defibrillator 
      interventions (n = 5), and nonarrhythmic death (n = 3; P = .006). CONCLUSION: In 
      survivors of OHCA, early CMR with a comprehensive tissue characterization 
      protocol provided additional diagnostic and prognostic value. The identification 
      of myocardial edema was associated with a favorable long-term outcome.
CI  - Copyright (c) 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights 
      reserved.
FAU - Zorzi, Alessandro
AU  - Zorzi A
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy.
FAU - Susana, Angela
AU  - Susana A
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy.
FAU - De Lazzari, Manuel
AU  - De Lazzari M
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy.
FAU - Migliore, Federico
AU  - Migliore F
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy.
FAU - Vescovo, Giovanni
AU  - Vescovo G
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy.
FAU - Scarpa, Daniele
AU  - Scarpa D
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy.
FAU - Baritussio, Anna
AU  - Baritussio A
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy; Bristol NIHR Cardiovascular Biomedical 
      Research Unit, Bristol Heart Institute, University of Bristol, Bristol, United 
      Kingdom.
FAU - Tarantini, Giuseppe
AU  - Tarantini G
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy.
FAU - Cacciavillani, Luisa
AU  - Cacciavillani L
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy.
FAU - Giorgi, Benedetta
AU  - Giorgi B
AD  - Division of Radiology, Department of Medicine, Az. Ospedaliera di Padova, Padova, 
      Italy.
FAU - Basso, Cristina
AU  - Basso C
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy.
FAU - Iliceto, Sabino
AU  - Iliceto S
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy.
FAU - Bucciarelli Ducci, Chiara
AU  - Bucciarelli Ducci C
AD  - Bristol NIHR Cardiovascular Biomedical Research Unit, Bristol Heart Institute, 
      University of Bristol, Bristol, United Kingdom.
FAU - Corrado, Domenico
AU  - Corrado D
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy. Electronic address: 
      domenico.corrado@unipd.it.
FAU - Perazzolo Marra, Martina
AU  - Perazzolo Marra M
AD  - Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, 
      University of Padova, Padova, Italy.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180315
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
MH  - Adult
MH  - Aged
MH  - Coronary Angiography
MH  - Coronary Artery Disease/complications/diagnosis/mortality
MH  - *Early Diagnosis
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Italy/epidemiology
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Out-of-Hospital Cardiac Arrest/*diagnosis/epidemiology/etiology
MH  - Prognosis
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Survival Rate/trends
MH  - Time Factors
OTO - NOTNLM
OT  - Cardiac arrest
OT  - Cardiac blunt trauma
OT  - Cardiac magnetic resonance
OT  - Cardiopulmonary resuscitation
OT  - Implantable cardioverter-defibrillator
OT  - Secondary prevention
OT  - Ventricular arrhythmia
EDAT- 2018/03/20 06:00
MHDA- 2019/01/17 06:00
CRDT- 2018/03/19 06:00
PHST- 2017/12/12 00:00 [received]
PHST- 2018/03/20 06:00 [pubmed]
PHST- 2019/01/17 06:00 [medline]
PHST- 2018/03/19 06:00 [entrez]
AID - S1547-5271(18)30195-4 [pii]
AID - 10.1016/j.hrthm.2018.02.033 [doi]
PST - ppublish
SO  - Heart Rhythm. 2018 Jul;15(7):1031-1041. doi: 10.1016/j.hrthm.2018.02.033. Epub 
      2018 Mar 15.