Myocardial Fibrosis as a Predictor of Sudden Death in Patients With Coronary Artery Disease

التفاصيل البيبلوغرافية
العنوان: Myocardial Fibrosis as a Predictor of Sudden Death in Patients With Coronary Artery Disease
المؤلفون: T. Qiu, Abbasin Zegard, Manish Kalla, Lucy Hudsmith, Osita Okafor, Richard P. Steeds, Berthold Stegemann, Joseph DeBono, Francisco Leyva, Howard Marshall, M Lencioni
المصدر: Journal of the American College of Cardiology. 77:29-41
بيانات النشر: Elsevier BV, 2021.
سنة النشر: 2021
مصطلحات موضوعية: medicine.medical_specialty, Objective (goal), medicine.medical_treatment, 030204 cardiovascular system & hematology, Ventricular tachycardia, Sudden death, Sudden cardiac death, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, medicine, In patient, cardiovascular diseases, 030212 general & internal medicine, Ejection fraction, business.industry, Hazard ratio, Coronary arteriosclerosis, medicine.disease, Implantable cardioverter-defibrillator, Ventricular fibrillation, cardiovascular system, Cardiology, Myocardial fibrosis, Cardiology and Cardiovascular Medicine, business
الوصف: Funding Acknowledgements Type of funding sources: None. BACKGROUND The ‘grayzone’ of myocardial fibrosis (GZF) on cardiovascular magnetic resonance may be a substrate for ventricular arrhythmias (VAs). OBJECTIVES To determine whether GZF predicts SCD and VAs (ventricular fibrillation or sustained ventricular tachycardia) in patients with coronary artery disease (CAD) and a wide range of LVEFs. METHODS In this retrospective study of CAD patients, myocardial fibrosis presence on visual assessment (MFVA) and GZF mass in patients with MFVA was assessed in relation to SCD and the composite, arrhythmic endpoint of SCD or VAs. RESULTS Among 979 patients (age: 65.8 ± 12.3 yrs [mean ± SD]), 29(2.96%) suffered a SCD and 80(8.17%) met the arrhythmic endpoint over 5.82 years (median; interquartile range: 4.1-7.3). In the whole cohort, MFVA was strongly associated with SCD (hazard ratio [HR]:10.1, 95% CI 1.42-1278.9) and the arrhythmic endpoint (HR:28.0, 95% CI 4.07-3525.4). In competing risks analyses, associations between LVEF 5.0 g was strongly associated with SCD (sHR:10.8, 95% CI 3.74-30.9) and the arrhythmic endpoint (sHR:7.40, 95% CI 4.29-12.8). Associations between LVEF CONCLUSIONS In CAD patients, MFVA plus quantified GZF3SD mass was more strongly associated with SCD and VAs than LVEF. In selecting patients for implantable cardioverter defibrillators, assessment of MFVA followed by quantification of GZF3SD mass may be preferable to LVEF. Abstract Figure.
تدمد: 0735-1097
DOI: 10.1016/j.jacc.2020.10.046
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7df53683fc0baf11cdb470f77c2942fb
https://doi.org/10.1016/j.jacc.2020.10.046
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....7df53683fc0baf11cdb470f77c2942fb
قاعدة البيانات: OpenAIRE
الوصف
تدمد:07351097
DOI:10.1016/j.jacc.2020.10.046