PMID- 31094736
OWN - NLM
STAT- MEDLINE
DCOM- 20200515
LR  - 20200515
IS  - 1535-2811 (Electronic)
IS  - 1535-2811 (Linking)
VI  - 18
IP  - 2
DP  - 2019 Jun
TI  - Myocardial Fibrosis as a Pathway of Prediction of Ventricular Arrhythmias and 
      Sudden Cardiac Death in Patients With Nonischemic Dilated Cardiomyopathy.
PG  - 89-97
LID - 10.1097/HPC.0000000000000171 [doi]
AB  - The mechanism of sudden cardiac death (SCD) in patients with nonischemic dilated 
      cardiomyopathy (NIDCM) is mostly due to sustained ventricular tachycardia and 
      ventricular fibrillation. The clinical guidelines for the therapeutic management 
      of this set of patients are mostly based on left ventricular ejection fraction 
      value which has a low specificity to differentiate the risk of SCD from the risk 
      of mortality associated with heart failure or other comorbidities. Moreover, 
      since SCD can occur in patients with normal or mildly depressed ejection 
      fraction, it is necessary to identify new markers to improve the prognostic 
      stratification of SCD. Several studies that analyzed the ventricular arrhythmia 
      substrate found that myocardial fibrosis plays an important role in the genesis 
      of ventricular arrhythmias in patients with NIDCM. The surrounding zone of the 
      area of fibrosis is a heterogeneous medium, where tissue with different levels of 
      fibrosis coexists, resulting in both viable and nonviable myocardium. This 
      myocardial fibrosis may constitute a substrate for ventricular arrhythmias, where 
      slow and heterogeneous conduction may favor the genesis of reentry mechanism 
      increasing the chance to develop sustained ventricular tachycardia or ventricular 
      fibrillation. Therefore, the evaluation of ventricular fibrosis by late 
      gadolinium enhancement (LGE) cardiac magnetic resonance imaging has been 
      suggested as an indicator for SCD risk stratification. Indeed, LGE in patients 
      with NIDCM is associated with increased risk of all-cause mortality, heart 
      failure hospitalization, and SCD. Detection of myocardial fibrosis as LGE by 
      cardiac magnetic resonance imaging can be considered as a useful pathway of 
      prediction of malignant ventricular arrhythmias since it has excellent prognostic 
      characteristics and may help guide risk stratification and management in patients 
      with NIDCM.
FAU - Centurion, Osmar Antonio
AU  - Centurion OA
AD  - From the Division of Cardiovascular Medicine, Clinic Hospital, Asuncion National 
      University (UNA), San Lorenzo, Paraguay.
AD  - Department of Health Sciences Investigation, Sanatorio Metropolitano, Fernando de 
      la Mora, Paraguay.
FAU - Alderete, Jose Fernando
AU  - Alderete JF
AD  - From the Division of Cardiovascular Medicine, Clinic Hospital, Asuncion National 
      University (UNA), San Lorenzo, Paraguay.
FAU - Torales, Judith Maria
AU  - Torales JM
AD  - From the Division of Cardiovascular Medicine, Clinic Hospital, Asuncion National 
      University (UNA), San Lorenzo, Paraguay.
AD  - Department of Health Sciences Investigation, Sanatorio Metropolitano, Fernando de 
      la Mora, Paraguay.
FAU - Garcia, Laura Beatriz
AU  - Garcia LB
AD  - From the Division of Cardiovascular Medicine, Clinic Hospital, Asuncion National 
      University (UNA), San Lorenzo, Paraguay.
AD  - Department of Health Sciences Investigation, Sanatorio Metropolitano, Fernando de 
      la Mora, Paraguay.
FAU - Scavenius, Karina Elizabeth
AU  - Scavenius KE
AD  - From the Division of Cardiovascular Medicine, Clinic Hospital, Asuncion National 
      University (UNA), San Lorenzo, Paraguay.
FAU - Mino, Luis Marcelo
AU  - Mino LM
AD  - From the Division of Cardiovascular Medicine, Clinic Hospital, Asuncion National 
      University (UNA), San Lorenzo, Paraguay.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Crit Pathw Cardiol
JT  - Critical pathways in cardiology
JID - 101165286
SB  - IM
MH  - Cardiomyopathy, Dilated/complications/diagnosis/physiopathology
MH  - Death, Sudden, Cardiac/etiology/*prevention & control
MH  - Fibrosis
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Risk Assessment/*methods
MH  - *Ventricular Fibrillation/diagnosis/etiology/prevention & control
EDAT- 2019/05/17 06:00
MHDA- 2020/05/16 06:00
CRDT- 2019/05/17 06:00
PHST- 2019/05/17 06:00 [entrez]
PHST- 2019/05/17 06:00 [pubmed]
PHST- 2020/05/16 06:00 [medline]
AID - 00132577-201906000-00007 [pii]
AID - 10.1097/HPC.0000000000000171 [doi]
PST - ppublish
SO  - Crit Pathw Cardiol. 2019 Jun;18(2):89-97. doi: 10.1097/HPC.0000000000000171.