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Risk stratification for sudden cardiac death in patients with heart failure : Emerging role of imaging parameters
Ikram Kammoun1, Emna Bennour2, Lobna Laroussi2
1Department of Cardiology, Ariana Hospital, 2080, Ariana, Tunisia. kammounikram@yahoo.fr.
Insights
Noninvasive imaging, including echocardiography and cardiac MRI, shows promise in identifying patients with heart failure at risk of sudden cardiac death (SCD). These techniques may improve risk stratification beyond traditional left ventricular ejection fraction.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Heart failure with reduced ejection fraction (HFrEF) carries a poor prognosis, with sudden cardiac death (SCD) a significant risk.
- Current methods for identifying SCD risk in HFrEF, primarily left ventricular ejection fraction, are insufficient.
- Noninvasive imaging techniques assessing myocardial deformation offer new insights into SCD mechanisms.
Purpose of the Study:
- To review the emerging role of novel noninvasive imaging parameters in identifying high-risk patients with HFrEF.
- To highlight the utility of myocardial deformation assessment in predicting sudden cardiac death.
Main Methods:
- A literature search was conducted using terms related to sudden cardiac death, heart failure, and noninvasive imaging modalities.
- Included studies focused on echocardiography, magnetic resonance imaging, and deformation parameters.
- The search was limited to English-language publications.
Main Results:
- Cardiac magnetic resonance imaging and echocardiographic strain assessment, especially longitudinal strain, show potential for cardiovascular risk stratification in heart failure patients.
- These imaging techniques provide valuable data for predicting adverse cardiac events.
Conclusions:
- Future risk stratification for arrhythmias and implantable cardioverter-defibrillator (ICD) selection in heart failure may involve a multiparametric approach.
- Combining imaging modalities with left ventricular ejection fraction offers a more comprehensive assessment of SCD risk.
Background:
Heart failure with reduced ejection fraction is a common condition that has a poor prognosis. Accurate selection of patients with ischemic heart disease and idiopathic dilated cardiomyopathy, who are at risk of sudden cardiac death (SCD), remains a challenge. In these cases, current indications for implantable cardioverter-defibrillators (ICD) rely almost entirely on left ventricular ejection fraction. However, this parameter is insufficient. Recently, noninvasive imaging has provided insight into the mechanism underlying SCD using myocardial deformation on echocardiography and magnetic resonance imaging. The aim of this review article was to underline the emerging role of these novel parameters in identifying high-risk patients.
Methods:
A literature search was carried out for reports published with the following terms: "sudden cardiac death," "heart failure," "noninvasive imaging," "echocardiography," "deformation," "magnetic resonance imaging," and "ventricular arrhythmia." The search was restricted to reports published in English.
Results:
The findings of this analysis suggest that cardiac magnetic resonance imaging and strain assessment by echocardiography, particularly longitudinal strain, can be promising techniques for cardiovascular risk stratification in patients with heart failure.
Conclusion:
In future, risk stratification of arrhythmia and patient selection for ICD placement may rely on a multiparametric approach using combinations of imaging modalities in addition to left ventricular ejection fraction.
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