PMID- 32299760 OWN - NLM STAT- MEDLINE DCOM- 20210413 LR - 20210413 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 29 IP - 9 DP - 2020 Sep TI - Septal Late Gadolinium Enhancement and Arrhythmic Risk in Genetic and Acquired Non-Ischaemic Cardiomyopathies. PG - 1356-1365 LID - S1443-9506(19)31457-X [pii] LID - 10.1016/j.hlc.2019.08.018 [doi] AB - BACKGROUND: In many genetic and acquired non-ischaemic cardiomyopathies (NICM) there have been frequent reports of involvement of the interventricular septum (IVS) by late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR). However, no studies have investigated the relationship between septal LGE and arrhythmias in different NICM subtypes. METHODS: This study enrolled 103 patients with septal LGE at baseline CMR and different NICM: hypertrophic (n=29) or lamin A/C gene (LMNA)-associated (n=23) cardiomyopathy, and acute (n=30) or previous (n=21) myocarditis. During follow-up, the occurrences of malignant ventricular arrhythmias (MVA) and major bradyarrhythmias (BA) were evaluated. RESULTS: At 4.9+/-0.7 years of follow-up, the occurrence of MVA and major BA in genetic vs acquired NICM were 10 of 52 vs 12 of 51, and 10 of 52 vs 4 of 51, respectively (both p=n.s.). However, MVA occurred more frequently in LMNA-NICM (eight of 23 vs two of 29 hypertrophic, p=0.015) and in previous myocarditis (nine of 21 vs three of 30 acute, p=0.016), while major BAs were particularly common in LMNA-NICM patients only (nine of 23 vs one of 29 hypertrophic, p=0.003). Different patterns of septal LGE were consistently retrospectively identified at baseline CMR: junctional and limited to the base in 79.3% of uneventful hypertrophic NICM; extended and focally transmural in LMNA-NICM with follow-up arrhythmias (both p<0.05); transitory in patients with acute myocarditis, who, differently from the post-myocarditis ones, showed follow-up arrhythmias only in the presence of unmodified LGE at follow-up CMR (five of 13, p=0.009). CONCLUSION: Septal LGE was significantly associated with MVA at the 5-year follow-up in LMNA-NICM or previous myocarditis, and with major BA in LMNA-NICM only. These differences correlated with heterogeneous patterns of IVS LGE in different NICM. CI - Copyright (c) 2019 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. FAU - Peretto, Giovanni AU - Peretto G AD - Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy. Electronic address: peretto.giovanni@hsr.it. FAU - Sala, Simone AU - Sala S AD - Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy. FAU - Lazzeroni, Davide AU - Lazzeroni D AD - Department of Clinical Cardiology and Primary Cardiomyopathies Unit, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy. FAU - Palmisano, Anna AU - Palmisano A AD - Department of Cardiovascular Imaging and Cardiac Magnetic Resonance Unit, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy. FAU - Gigli, Lorenzo AU - Gigli L AD - Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy. FAU - Esposito, Antonio AU - Esposito A AD - Department of Cardiovascular Imaging and Cardiac Magnetic Resonance Unit, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy. FAU - De Cobelli, Francesco AU - De Cobelli F AD - Department of Cardiovascular Imaging and Cardiac Magnetic Resonance Unit, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy. FAU - Camici, Paolo G AU - Camici PG AD - Department of Clinical Cardiology and Primary Cardiomyopathies Unit, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy. FAU - Mazzone, Patrizio AU - Mazzone P AD - Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy. FAU - Basso, Cristina AU - Basso C AD - Department of Cardiovascular Pathology, Padua University Hospital, Padua, Italy. FAU - Della Bella, Paolo AU - Della Bella P AD - Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy. LA - eng PT - Journal Article DEP - 20191115 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Adult MH - Arrhythmias, Cardiac/*diagnosis/etiology/physiopathology MH - Cardiomyopathies/*diagnosis/etiology/physiopathology MH - Contrast Media/pharmacology MH - Female MH - Follow-Up Studies MH - Gadolinium/*pharmacology MH - Heart Ventricles/*diagnostic imaging/physiopathology MH - Humans MH - Magnetic Resonance Imaging, Cine/*methods MH - Male MH - Middle Aged MH - Retrospective Studies MH - Stroke Volume MH - Time Factors MH - Ventricular Function, Left/*physiology MH - Ventricular Septum/*diagnostic imaging OTO - NOTNLM OT - Bradyarrhythmias OT - Cardiac magnetic resonance OT - Cardiomyopathy OT - Late gadolinium enhancement OT - Myocarditis OT - Ventricular arrhythmias EDAT- 2020/04/18 06:00 MHDA- 2021/04/14 06:00 CRDT- 2020/04/18 06:00 PHST- 2019/05/14 00:00 [received] PHST- 2019/08/25 00:00 [revised] PHST- 2019/08/30 00:00 [accepted] PHST- 2020/04/18 06:00 [pubmed] PHST- 2021/04/14 06:00 [medline] PHST- 2020/04/18 06:00 [entrez] AID - S1443-9506(19)31457-X [pii] AID - 10.1016/j.hlc.2019.08.018 [doi] PST - ppublish SO - Heart Lung Circ. 2020 Sep;29(9):1356-1365. doi: 10.1016/j.hlc.2019.08.018. Epub 2019 Nov 15.