PMID- 29931686 OWN - NLM STAT- MEDLINE DCOM- 20190412 LR - 20190412 IS - 1540-8159 (Electronic) IS - 0147-8389 (Linking) VI - 41 IP - 9 DP - 2018 Sep TI - Absence of late gadolinium enhancement on cardiac magnetic resonance imaging in ventricular fibrillation and nonischemic cardiomyopathy. PG - 1109-1115 LID - 10.1111/pace.13426 [doi] AB - INTRODUCTION: Cardiac magnetic resonance (CMR)-identified late gadolinium enhancement (LGE), representing regional fibrosis, is often used to predict ventricular arrhythmia risk in nonischemic cardiomyopathy (NICM). However, LGE is more closely correlated with sustained monomorphic ventricular tachycardia (SMVT) than ventricular fibrillation (VF). We characterized CMR findings of ventricular LGE in VF survivors. METHODS: We examined consecutively resuscitated VF survivors undergoing contrast-enhanced 1.5T CMR between 9/2007 and 7/2016. We excluded coronary artery disease, hypertrophic cardiomyopathy, amyloid, sarcoid, arrhythmogenic right ventricular cardiomyopathy, and channelopathy. Preexisting implantable cardioverter-defibrillator (ICD) was a CMR contraindication. VF patients were divided into three groups: (1) NICM, (2) left ventricular (LV) dilatation with normal LV ejection fraction (LVEF), and (3) normal LV size and LVEF. Two groups of NICM patients with and without SMVT were examined for comparison. RESULTS: We analyzed 87 VF patients, and found that LGE was seen in 8/22 (36%) with NICM (LVEF 38 +/- 11%, LV end-diastolic volume index [LVEDVI] 134 +/- 68 mL/BSA), 11/40 (28%) with LV dilatation and normal LVEF (LVEDVI 103 +/- 17 mL/BSA), 4/25 (16%) with normal LV size and LVEF. Incidence of LGE in NICM patients without prior ventricular tachycardia/VF (LVEF 36 +/- 12%, LVEDVI 141 +/- 46 mL/body surface area [BSA]) was 117/277 and was not lower than those with VF and NICM (42% vs 36%; P = 0.59). By contrast, 22/37 NICM patients with SMVT (LVEF 42 +/- 11%, LVEDVI 123 +/- 48 mL/BSA) were LGE-positive (59% NICM-SMVT vs 36% NICM-VF; P = 0.04). CONCLUSION: Most VF survivors with a diagnosis of NICM did not have LGE on CMR and would not have met primary prevention ICD criteria based on LVEF. Absence of LGE may not portend a benign prognosis in NICM. Novel strategies for determining SCD risk in this cohort are required. CI - (c) 2018 Wiley Periodicals, Inc. FAU - Voskoboinik, Aleksandr AU - Voskoboinik A AUID- ORCID: 0000-0001-6990-302X AD - Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia. AD - Baker Heart & Diabetes Institute, Melbourne, Australia. AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. FAU - Wong, Michael C G AU - Wong MCG AD - Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia. AD - Department of Cardiology, Western Health, Melbourne, Australia. FAU - Elliott, Jessica K AU - Elliott JK AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. FAU - Costello, Benedict T AU - Costello BT AD - Baker Heart & Diabetes Institute, Melbourne, Australia. AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. FAU - Prabhu, Sandeep AU - Prabhu S AD - Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia. AD - Baker Heart & Diabetes Institute, Melbourne, Australia. AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. FAU - Mariani, Justin A AU - Mariani JA AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. FAU - Kalman, Jonathan M AU - Kalman JM AD - Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia. AD - Department of Medicine, University of Melbourne, Melbourne, Australia. FAU - Kistler, Peter M AU - Kistler PM AD - Baker Heart & Diabetes Institute, Melbourne, Australia. AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. AD - Department of Medicine, University of Melbourne, Melbourne, Australia. FAU - Taylor, Andrew J AU - Taylor AJ AD - Baker Heart & Diabetes Institute, Melbourne, Australia. AD - Heart Centre, The Alfred Hospital, Melbourne, Australia. FAU - Morton, Joseph B AU - Morton JB AD - Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia. AD - Department of Medicine, University of Melbourne, Melbourne, Australia. LA - eng PT - Journal Article DEP - 20180716 PL - United States TA - Pacing Clin Electrophysiol JT - Pacing and clinical electrophysiology : PACE JID - 7803944 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Adult MH - Cardiomyopathies/*diagnostic imaging/physiopathology MH - Contrast Media MH - Coronary Angiography MH - Echocardiography MH - Electrocardiography MH - Female MH - Gadolinium MH - Humans MH - Magnetic Resonance Imaging/*methods MH - Male MH - Middle Aged MH - Predictive Value of Tests MH - Retrospective Studies MH - Ventricular Fibrillation/*diagnostic imaging/physiopathology OTO - NOTNLM OT - arrest OT - cardiac OT - magnetic resonance OT - nonischemic OT - ventricular fibrillation EDAT- 2018/06/23 06:00 MHDA- 2019/04/13 06:00 CRDT- 2018/06/23 06:00 PHST- 2018/02/06 00:00 [received] PHST- 2018/03/18 00:00 [revised] PHST- 2018/06/12 00:00 [accepted] PHST- 2018/06/23 06:00 [pubmed] PHST- 2019/04/13 06:00 [medline] PHST- 2018/06/23 06:00 [entrez] AID - 10.1111/pace.13426 [doi] PST - ppublish SO - Pacing Clin Electrophysiol. 2018 Sep;41(9):1109-1115. doi: 10.1111/pace.13426. Epub 2018 Jul 16.