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CMR-Based Risk Stratification of Sudden Cardiac Death and Use of Implantable Cardioverter-Defibrillator in

Laura Keil1, Céleste Chevalier1, Paulus Kirchhof1,2

  • 1Clinic for Cardiology, University Heart and Vascular Center Hamburg Eppendorf, 20246 Hamburg, Germany.

International Journal of Molecular Sciences
|July 20, 2021
PubMed

Insights

Non-ischemic cardiomyopathy (NICM) patients may benefit from implantable cardioverter-defibrillators (ICDs). Cardiovascular magnetic resonance imaging (CMR) aids in identifying NICM patients who will benefit most from ICD therapy for sudden cardiac death prevention.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Genetics

Background:

  • Non-ischemic cardiomyopathy (NICM) is a significant cause of sudden cardiac death (SCD).
  • Current guidelines do not differentiate ICD implantation recommendations between NICM and ischemic cardiomyopathy (ICM).
  • Improved risk stratification is needed for NICM patients to identify those who benefit from ICD therapy.

Purpose of the Study:

  • To review the epidemiological aspects of SCD in NICM.
  • To evaluate the role of cardiovascular magnetic resonance imaging (CMR) in risk stratification for SCD in NICM.
  • To discuss resulting indications for implantable cardioverter-defibrillator (ICD) implantation in NICM.

Main Methods:

  • Review of existing epidemiological data on SCD in NICM.
  • Analysis of studies investigating CMR parameters (late gadolinium enhancement, T1 relaxation times, myocardial strain) for SCD risk stratification.
  • Evaluation of established predictors (genetic mutations, LVEF, LVEDD, TWA) alongside CMR findings.

Main Results:

  • CMR offers comprehensive analysis of cardiac function and myocardial tissue composition, potentially improving risk stratification.
  • Specific CMR parameters like LGE, T1 relaxation times, and myocardial strain are associated with SCD risk in NICM.
  • Integrating CMR with clinical and genetic predictors may refine patient selection for ICD therapy.

Conclusions:

  • Cardiovascular magnetic resonance imaging (CMR) shows promise in enhancing risk stratification for sudden cardiac death (SCD) in non-ischemic cardiomyopathy (NICM).
  • Further research integrating CMR with other predictors can optimize implantable cardioverter-defibrillator (ICD) implantation decisions in NICM patients.
  • Personalized risk assessment using advanced imaging is crucial for preventing SCD in NICM.

Keywords:
cardiovascular magnetic resonance imagingdilated cardiomyopathynon-ischemic cardiomyopathyrisk stratificationsudden cardiac death

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