Left Ventricular Late Gadolinium Enhancement for Arrhythmic Risk Prediction in ARVC

Corrado De Marco1, Babken Asatryan2, Anneline S J M Te Riele3,4

  • 1Cardiovascular Genetics Center and Electrophysiology Service, Montreal Heart Institute, Department of Medicine, Université de Montréal, QC, Canada (C.D.M., R.T., L.-P.D., J.C.-T.).

Insights

Left ventricular late gadolinium enhancement (LV LGE) on cardiac magnetic resonance is associated with ventricular arrhythmia (VA) risk in arrhythmogenic right ventricular cardiomyopathy (ARVC). However, LV LGE does not improve risk prediction beyond the existing ARVC risk calculator.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Genetics

Background:

  • Arrhythmogenic right ventricular cardiomyopathy (ARVC) poses a risk for sustained ventricular arrhythmia (VA).
  • Current ARVC risk calculators do not incorporate left ventricular (LV) structure or function.
  • Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) shows potential for predicting arrhythmic events.

Purpose of the Study:

  • To determine if LV LGE on CMR can enhance risk stratification for VA in ARVC patients.
  • To assess the incremental prognostic value of LV LGE compared to the established ARVC risk calculator.

Main Methods:

  • A cohort of 385 ARVC patients without prior VA underwent baseline CMR.
  • Survival analysis and Cox proportional hazard models were used to evaluate LV LGE's impact on VA prediction.
  • High-risk LV LGE patterns (epicardial, transmural, combined septal/free-wall) were analyzed.

Main Results:

  • 132 patients (34.3%) had LV LGE, with 98 (25.5%) exhibiting a high-risk pattern.
  • During follow-up (3.1 years), 67 patients (17.4%) experienced VA.
  • While LV LGE was associated with VA risk in univariable analysis, it did not independently predict VA after adjusting for the ARVC risk calculator score.

Conclusions:

  • LV LGE is associated with VA risk in ARVC patients.
  • LV LGE does not offer additional prognostic information for predicting incident VA when used with the current ARVC risk calculator.
Abstract

Related Concept Videos

Predicting Molecular Geometry02:27

Predicting Molecular Geometry

VSEPR Theory for Determination of Electron Pair Geometries
45.7K
Relative Risk01:12

Relative Risk

Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...
2.1K
Prediction Intervals01:03

Prediction Intervals

The interval estimate of any variable is known as the prediction interval. It helps decide if a point estimate is dependable.
However, the point estimate is most likely not the exact value of the population parameter, but close to it. After calculating point estimates, we construct interval estimates, called confidence intervals or prediction intervals. This prediction interval comprises a range of values unlike the point estimate and is a better predictor of the observed sample value, y. 
3.4K
Factors Affecting the Risk of Infection01:26

Factors Affecting the Risk of Infection

The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
13.5K
Self-Evaluation: Self-Enhancement and Self-Verification03:00

Self-Evaluation: Self-Enhancement and Self-Verification

Social psychologists have documented that feeling good about ourselves and maintaining positive self-esteem is a powerful motivator of human behavior (Tavris & Aronson, 2008). In the United States, members of the predominant culture typically think very highly of themselves and view themselves as good people who are above average on many desirable traits (Ehrlinger, Gilovich, & Ross, 2005). Often, our behavior, attitudes, and beliefs are affected when we experience a threat to our...
5.8K
End Point Prediction: Gran Plot01:07

End Point Prediction: Gran Plot

A Gran plot is used to predict the equivalence volume or endpoint of a potentiometric or acid-base titration without reaching the endpoint. Typically, titration data is collected as a function of the titrant's volume up to a point less than the equivalence volume and then transformed into a linear format. The straight line is extended to the x-axis, indicating the necessary titrant volume to achieve the equivalence point.
For potentiometric titration, the Gran plot is created by plotting...
1.2K