PMID- 29654132
OWN - NLM
STAT- MEDLINE
DCOM- 20190812
LR  - 20190812
IS  - 1941-3084 (Electronic)
IS  - 1941-3084 (Linking)
VI  - 11
IP  - 4
DP  - 2018 Apr
TI  - Mortality and Sudden Cardiac Death Risk Stratification Using the Noninvasive 
      Combination of Wide QRS Duration and Late Gadolinium Enhancement in Idiopathic 
      Dilated Cardiomyopathy.
PG  - e006233
LID - 10.1161/CIRCEP.117.006233 [doi]
AB  - BACKGROUND: The aim of this study was to investigate whether the combination of 
      QRS duration >/=120 ms (wide QRS duration [wQRS]) and late gadolinium enhancement 
      (LGE) is a precise prognostic indicator for dilated cardiomyopathy. METHODS AND 
      RESULTS: We investigated the association between the combination of LGE plus wQRS 
      and the primary end point (all-cause death) and a composite of sudden cardiac 
      death (SCD) or aborted SCD in 531 patients with dilated cardiomyopathy. We also 
      analyzed the association between the combination of LGE and wQRS and these end 
      points among patients with a class I indication for implantable cardioverter 
      defibrillator implantation. We divided study patients into 3 groups according to 
      LGE status and QRS duration: 2 negative indices (LGE negative and narrow QRS), 1 
      positive index (LGE positive or wQRS), or 2 positive indices (LGE positive and 
      wQRS), and followed them for 3.8 years. Multivariable Cox regression analysis 
      identified 2 positive indices as a significant predictor of all-cause death 
      (hazard ratio, 4.29 [1.19-15.47]; P=0.026). Among 317 patients with a class I 
      indication for implantable cardioverter defibrillator, the 5-year event rate of 
      SCD or aborted SCD was the lowest in the 2 negative indices group (1.4%). With 
      propensity score-matching cohorts, the 2 negative indices group had a 
      significantly lower event rate of SCD or aborted SCD than the other 2 groups 
      (hazard ratio, 0.12 [0.01-0.97]; P=0.046). CONCLUSIONS: The combination of LGE 
      and wQRS provides additional prognostic stratification compared with LGE status 
      alone and might improve the appropriate use of implantable cardioverter 
      defibrillator therapy in patients with dilated cardiomyopathy.
CI  - (c) 2018 American Heart Association, Inc.
FAU - Marume, Kyohei
AU  - Marume K
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Noguchi, Teruo
AU  - Noguchi T
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan. tnoguchi@ncvc.go.jp.
FAU - Tateishi, Emi
AU  - Tateishi E
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Morita, Yoshiaki
AU  - Morita Y
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Kamakura, Tsukasa
AU  - Kamakura T
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Ishibashi, Kohei
AU  - Ishibashi K
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Noda, Takashi
AU  - Noda T
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Miura, Hiroyuki
AU  - Miura H
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Nishimura, Kunihiro
AU  - Nishimura K
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Nakai, Michikazu
AU  - Nakai M
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Yamada, Naoaki
AU  - Yamada N
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Tsujita, Kenichi
AU  - Tsujita K
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Anzai, Toshihisa
AU  - Anzai T
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Kusano, Kengo
AU  - Kusano K
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Ogawa, Hisao
AU  - Ogawa H
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
FAU - Yasuda, Satoshi
AU  - Yasuda S
AD  - Departments of Cardiovascular Medicine (K.M., K.I., T.N., H.M., K.K., H.O., 
      S.Y.), Radiology (E.T., Y.M.), and Statistics and Data Analysis (K.N., M.N.), 
      National Cerebral and Cardiovascular Center, Suita, Japan. Department of 
      Radiology, Osaka Neurological Institute, Toyonaka, Japan (N.Y.). Department of 
      Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, 
      Sapporo, Japan (T.A.). Departments of Cardiovascular Medicine (K.M., K.T.) and 
      Advanced Cardiovascular Medicine (T.A., K.K., S.Y.), Graduate School of Medical 
      Sciences, Kumamoto University, Japan.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Circ Arrhythm Electrophysiol
JT  - Circulation. Arrhythmia and electrophysiology
JID - 101474365
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
MH  - *Action Potentials
MH  - Adult
MH  - Aged
MH  - Cardiomyopathy, Dilated/*diagnosis/mortality/physiopathology/therapy
MH  - Clinical Decision-Making
MH  - Contrast Media/*administration & dosage
MH  - Death, Sudden, Cardiac/*etiology/prevention & control
MH  - Defibrillators, Implantable
MH  - Electric Countershock/instrumentation
MH  - *Electrocardiography
MH  - Female
MH  - Gadolinium DTPA/*administration & dosage
MH  - Humans
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Stroke Volume
MH  - Time Factors
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - cardiomyopathy, dilated
OT  - death, sudden, cardiac
OT  - defibrillators
OT  - implantable
OT  - magnetic resonance imaging
OT  - prognosis
EDAT- 2018/04/15 06:00
MHDA- 2019/08/14 06:00
CRDT- 2018/04/15 06:00
PHST- 2018/01/16 00:00 [received]
PHST- 2018/02/26 00:00 [accepted]
PHST- 2018/04/15 06:00 [entrez]
PHST- 2018/04/15 06:00 [pubmed]
PHST- 2019/08/14 06:00 [medline]
AID - CIRCEP.117.006233 [pii]
AID - 10.1161/CIRCEP.117.006233 [doi]
PST - ppublish
SO  - Circ Arrhythm Electrophysiol. 2018 Apr;11(4):e006233. doi: 
      10.1161/CIRCEP.117.006233.