PMID- 32067833
OWN - NLM
STAT- MEDLINE
DCOM- 20220530
LR  - 20220530
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 307
DP  - 2020 May 15
TI  - The extent and location of late gadolinium enhancement predict defibrillator 
      shock and cardiac mortality in patients with non-ischaemic dilated 
      cardiomyopathy.
PG  - 180-186
LID - S0167-5273(19)35095-8 [pii]
LID - 10.1016/j.ijcard.2020.02.028 [doi]
AB  - BACKGROUND: In non-ischaemic dilated cardiomyopathy (NIDCM), it is uncertain 
      which late gadolinium enhancement (LGE) pattern, extent and location predict 
      ventricular arrhythmias. METHODS: We analysed 183 NIDCM patients (73% men, median 
      age 66 years) receiving an implantable cardioverter defibrillator (ICD) for 
      primary prevention, undergoing cardiac magnetic resonance within 1 month before 
      implantation. The primary endpoint was appropriate ICD shock, the secondary 
      endpoint was a composite of appropriate ICD shock and cardiac death. RESULTS: LGE 
      was found in 116 patients (63%), accounting for 9% of LV mass (5-13%). Over a 
      30-month follow-up (10-65), 20 patients (11%) experienced the primary and 30 
      patients (16%) the secondary endpoint. LGE presence, inferior wall LGE, diffuse 
      (>/=2 wall) LGE, the number of segments with LGE, the number of segments with 
      50-75% transmural LGE, and percent LGE mass were univariate predictors of both 
      endpoints. Also septal LGE predicted the primary, and lateral LGE predicted the 
      secondary endpoint. LGE limited to right ventricular insertion points did not 
      predict any endpoint. Percent LGE mass had an area under the curve of 0.734 for 
      the primary endpoint, with 13% as the best cut-off (55% sensitivity, 86% 
      specificity, 32% PPV, 94% NPV), conferring a 7-fold higher risk compared to 
      patients with no LGE or LGE <13%. Survival free from both endpoints was 
      significantly worse for patients with LGE >/=13%. CONCLUSIONS: In patients with 
      NIDCM receiving a defibrillator for primary prevention, LGE presence and extent 
      predicted appropriate ICD shock and cardiac mortality; also specific LGE patterns 
      and locations predicted a worse prognosis.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Barison, Andrea
AU  - Barison A
AD  - Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Institute of Life Sciences, 
      Scuola Superiore Sant'Anna, Pisa, Italy. Electronic address: 
      dr.andrea.barison@gmail.com.
FAU - Aimo, Alberto
AU  - Aimo A
AD  - Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
FAU - Mirizzi, Gianluca
AU  - Mirizzi G
AD  - Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Institute of Life Sciences, 
      Scuola Superiore Sant'Anna, Pisa, Italy.
FAU - Castiglione, Vincenzo
AU  - Castiglione V
AD  - Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
FAU - Ripoli, Andrea
AU  - Ripoli A
AD  - Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
FAU - Panchetti, Luca
AU  - Panchetti L
AD  - Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
FAU - Rossi, Andrea
AU  - Rossi A
AD  - Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
FAU - Giannoni, Alberto
AU  - Giannoni A
AD  - Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Institute of Life Sciences, 
      Scuola Superiore Sant'Anna, Pisa, Italy.
FAU - Startari, Umberto
AU  - Startari U
AD  - Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
FAU - Aquaro, Giovanni Donato
AU  - Aquaro GD
AD  - Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
FAU - Emdin, Michele
AU  - Emdin M
AD  - Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Institute of Life Sciences, 
      Scuola Superiore Sant'Anna, Pisa, Italy.
FAU - Piacenti, Marcello
AU  - Piacenti M
AD  - Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
LA  - eng
PT  - Journal Article
DEP - 20200211
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Aged
MH  - *Cardiomyopathies
MH  - *Cardiomyopathy, Dilated/diagnostic imaging/therapy
MH  - Contrast Media
MH  - *Defibrillators, Implantable
MH  - Female
MH  - Gadolinium
MH  - Humans
MH  - Male
MH  - Predictive Value of Tests
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Defibrillator
OT  - Late gadolinium enhancement
OT  - Prognosis
OT  - Shock
OT  - Ventricular arrhythmias
COIS- Declaration of competing interest None declared.
EDAT- 2020/02/19 06:00
MHDA- 2022/05/31 06:00
CRDT- 2020/02/19 06:00
PHST- 2019/10/22 00:00 [received]
PHST- 2020/01/12 00:00 [revised]
PHST- 2020/02/09 00:00 [accepted]
PHST- 2020/02/19 06:00 [pubmed]
PHST- 2022/05/31 06:00 [medline]
PHST- 2020/02/19 06:00 [entrez]
AID - S0167-5273(19)35095-8 [pii]
AID - 10.1016/j.ijcard.2020.02.028 [doi]
PST - ppublish
SO  - Int J Cardiol. 2020 May 15;307:180-186. doi: 10.1016/j.ijcard.2020.02.028. Epub 
      2020 Feb 11.