1. Prognostic Role of Late Gadolinium Enhancement in Patients With Hypertrophic Cardiomyopathy and Low-to-Intermediate Sudden Cardiac Death Risk Score
- Author
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Francesco Clemenza, Giuseppina Novo, Federica Re, Francesco Negri, Giovanni Gentile, Francesco Bianco, Giancarlo Todiere, Elisabetta Zachara, Calogero Falletta, Cinzia Nugara, Gianfranco Sinagra, Raffaele De Caterina, Gianluca Di Bella, Michele Emdin, Giovanni Donato Aquaro, Todiere, G., Nugara, C., Gentile, G., Negri, F., Bianco, F., Falletta, C., Novo, G., Di Bella, G., De Caterina, R., Zachara, E., Re, F., Clemenza, F., Sinagra, G., Emdin, M., Aquaro, G. D., Todiere G., Nugara C., Gentile G., Negri F., Bianco F., Falletta C., Novo G., Di Bella G., De Caterina R., Zachara E., Re F., Clemenza F., Sinagra G., Emdin M., and Aquaro G.D.
- Subjects
Male ,medicine.medical_treatment ,Left ,Cardiomyopathy ,Contrast Media ,Gadolinium ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,030218 nuclear medicine & medical imaging ,Sudden cardiac death ,0302 clinical medicine ,Risk Factors ,hemic and lymphatic diseases ,Ventricular Function ,Framingham Risk Score ,medicine.diagnostic_test ,Incidence ,Hypertrophic cardiomyopathy ,Middle Aged ,Implantable cardioverter-defibrillator ,Prognosis ,Magnetic Resonance Imaging ,Hypertrophic Cardiomyopathy, Sudden Cardiac Death ,Death ,Survival Rate ,Italy ,Cine ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,Cardiac ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Heart Ventricles ,Magnetic Resonance Imaging, Cine ,Risk Assessment ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Retrospective Studies ,business.industry ,Myocardium ,Magnetic resonance imaging ,Retrospective cohort study ,Cardiomyopathy, Hypertrophic ,Death, Sudden, Cardiac ,Follow-Up Studies ,ROC Curve ,medicine.disease ,Sudden ,Hypertrophic ,Complication ,business - Abstract
Sudden cardiac death (SCD) is the most life-threating complication of hypertrophic cardiomyopathy. Guidelines of the European Society of Cardiology (ESC) suggest the implantation of an implantable cardioverter defibrillator in primary prevention according to a 5-year risk SCD score >= 6%. The aim of the study is to evaluate the prognostic role of late gadolinium enhancement (LGE) in patients with a 5-year risk SCD score = 4 and = 10% was the best threshold to predict major arrhythmic events (area under the curve: 0.74). Kaplan-Meier curves showed that patients with LGE >= 10% had a worse prognosis than those with lower extent (p < 0.0001). LGE extent was the best independent predictor of hard cardiac events (hazard ratio 1.05; 95% confidence interval [CI] 1.03 to 107; p < 0.0001). The estimates 5-year risk of hard cardiac event was 2.5% (95% CI 0.8 to 4.2) in patients with LGE extent = 10%. In conclusion, this study demonstrates as the extent of LGE >= 10% is able to recognize additional patients at increased risk for malignant arrhythmic episodes in a population with low-to-intermediate ESC SCD risk score. (C) 2019 Elsevier Inc. All rights reserved.
- Published
- 2019