PMID- 30121262
OWN - NLM
STAT- MEDLINE
DCOM- 20200317
LR  - 20200317
IS  - 1876-7591 (Electronic)
IS  - 1876-7591 (Linking)
VI  - 12
IP  - 7 Pt 1
DP  - 2019 Jul
TI  - Left Ventricular Entropy Is a Novel Predictor of Arrhythmic Events in Patients 
      With Dilated Cardiomyopathy Receiving Defibrillators for Primary Prevention.
PG  - 1177-1184
LID - S1936-878X(18)30548-5 [pii]
LID - 10.1016/j.jcmg.2018.07.003 [doi]
AB  - OBJECTIVES: The aim of this study was to assess the utility of left ventricular 
      (LV) entropy, a novel measure of myocardial heterogeneity, for predicting 
      cardiovascular events in patients with dilated cardiomyopathy (DCM). BACKGROUND: 
      Current risk stratification for ventricular arrhythmia in patients with DCM is 
      imprecise. LV entropy is a measure of myocardial heterogeneity derived from 
      cardiac magnetic resonance imaging that assesses the probability distribution of 
      pixel signal intensities in the LV myocardium. METHODS: A registry-based cohort 
      of primary prevention implantable cardioverter-defibrillator patients with DCM 
      had their LV entropy, late gadolinium enhancement (LGE) presence, and LGE mass 
      measured on cardiac magnetic resonance imaging. Patients were followed from 
      implantable cardioverter-defibrillator placement for arrhythmic events 
      (appropriate implantable cardioverter-defibrillator therapy, ventricular 
      arrhythmia, or sudden cardiac death), end-stage heart failure events (cardiac 
      death, transplantation, or ventricular assist device placement), and all-cause 
      mortality. RESULTS: One hundred thirty patients (mean age 55 years, 83% men, LV 
      ejection fraction 29%, mean LV entropy 5.58 +/- 0.72, LGE present in 57%) were 
      followed for a median of 3.2 years. Eighteen (14.0%) experienced arrhythmic 
      events, 17 (13.1%) experienced end-stage heart failure events, and 7 (5.4%) died. 
      LV entropy provided substantial improvement of predictive ability when added to a 
      model containing clinical variables and LGE mass (hazard ratio: 3.5; 95% 
      confidence interval: 1.42 to 8.82; p = 0.007; net reclassification index = 0.345, 
      p = 0.04). For end-stage heart failure events, LV entropy did not improve the 
      model containing clinical variables and LGE mass (hazard ratio: 2.03; 95% 
      confidence interval: 0.78 to 5.28; p = 0.14). Automated LV entropy measurement 
      has excellent intraobserver (mean difference 0.04) and interobserver (mean 
      difference 0.03) agreement. CONCLUSIONS: Automated LV entropy measurement is a 
      novel marker for risk stratification toward ventricular arrhythmia in patients 
      with DCM.
CI  - Copyright (c) 2019. Published by Elsevier Inc.
FAU - Muthalaly, Rahul G
AU  - Muthalaly RG
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
FAU - Kwong, Raymond Y
AU  - Kwong RY
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
FAU - John, Roy M
AU  - John RM
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
FAU - van der Geest, Rob J
AU  - van der Geest RJ
AD  - Leiden University Medical Center, Leiden, the Netherlands.
FAU - Tao, Qian
AU  - Tao Q
AD  - Leiden University Medical Center, Leiden, the Netherlands.
FAU - Schaeffer, Benjamin
AU  - Schaeffer B
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
FAU - Tanigawa, Shinichi
AU  - Tanigawa S
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
FAU - Nakamura, Tomofumi
AU  - Nakamura T
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
FAU - Kaneko, Kyoichi
AU  - Kaneko K
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
FAU - Tedrow, Usha B
AU  - Tedrow UB
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
FAU - Stevenson, William G
AU  - Stevenson WG
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
FAU - Epstein, Laurence M
AU  - Epstein LM
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
FAU - Kapur, Sunil
AU  - Kapur S
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
FAU - Zei, Paul C
AU  - Zei PC
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
FAU - Koplan, Bruce A
AU  - Koplan BA
AD  - Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 
      Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic 
      address: bkoplan@bwh.harvard.edu.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180815
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
SB  - IM
CIN - JACC Cardiovasc Imaging. 2019 Jul;12(7 Pt 1):1185-1187. PMID: 30121274
MH  - Adult
MH  - Aged
MH  - Arrhythmias, Cardiac/diagnosis/mortality/physiopathology/*prevention & control
MH  - Cardiomyopathy, Dilated/diagnostic imaging/mortality/physiopathology/*therapy
MH  - Death, Sudden, Cardiac/prevention & control
MH  - *Defibrillators, Implantable
MH  - Electric Countershock/adverse effects/*instrumentation/mortality
MH  - Female
MH  - Humans
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Predictive Value of Tests
MH  - Primary Prevention/*instrumentation
MH  - Registries
MH  - Reproducibility of Results
MH  - Risk Factors
MH  - *Stroke Volume
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Ventricular Function, Left
OTO - NOTNLM
OT  - cardiomyopathy
OT  - implantable cardioverter-defibrillator
OT  - magnetic resonance imaging (MRI)
OT  - sudden cardiac death
EDAT- 2018/08/20 06:00
MHDA- 2020/03/18 06:00
CRDT- 2018/08/20 06:00
PHST- 2018/04/24 00:00 [received]
PHST- 2018/06/04 00:00 [revised]
PHST- 2018/07/03 00:00 [accepted]
PHST- 2018/08/20 06:00 [pubmed]
PHST- 2020/03/18 06:00 [medline]
PHST- 2018/08/20 06:00 [entrez]
AID - S1936-878X(18)30548-5 [pii]
AID - 10.1016/j.jcmg.2018.07.003 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2019 Jul;12(7 Pt 1):1177-1184. doi: 
      10.1016/j.jcmg.2018.07.003. Epub 2018 Aug 15.