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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

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Prognostic role of CMR in patients presenting with ventricular arrhythmias

Dana K Dawson1, Karin Hawlisch, Gordon Prescott

  • 1Cardiovascular Medicine Research Unit, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, United Kingdom. dana.dawson@abdn.ac.uk

JACC. Cardiovascular Imaging
|February 26, 2013
PubMed

Insights

Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) detected fibrosis is a key predictor of adverse cardiovascular events in patients with ventricular arrhythmia. This finding aids in risk stratification for sudden cardiac death.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Electrophysiology

Background:

  • Risk stratification for sudden cardiac death in patients with ventricular arrhythmia is challenging.
  • Identifying patients at high risk for adverse cardiovascular events is crucial for timely intervention.

Purpose of the Study:

  • To determine if fibrosis, detected by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR), independently predicts hard cardiovascular events in patients with ventricular arrhythmia.
  • To assess the role of LGE-CMR in risk stratification for patients with sustained and nonsustained ventricular tachycardia.

Main Methods:

  • A prospective study of 373 patients with sustained or nonsustained ventricular tachycardia who underwent LGE-CMR.
  • Median follow-up of 2.6 years for a composite endpoint of cardiac death/arrest, sustained VT, or appropriate ICD discharge.
  • Multivariate analysis to identify independent predictors of adverse outcomes.

Main Results:

  • Fibrosis detected by LGE-CMR was a strong independent predictor of the primary outcome in the overall group (HR: 3.3, p < 0.001).
  • In sustained VT patients, both LV fibrosis and LVEF <35% were independent predictors.
  • In NSVT patients, LGE-CMR-detected fibrosis was the sole independent predictor (HR: 4.2, p = 0.006).

Conclusions:

  • LGE-CMR-detected fibrosis is a significant independent predictor of adverse outcomes in patients with ventricular arrhythmia.
  • LGE-CMR plays a vital role in the risk stratification of patients with ventricular arrhythmias, guiding therapy decisions.
Abstract

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