Work

Arrhythmic Risk Stratification by Cardiovascular Magnetic Resonance Imaging in Patients With Nonischemic Cardiomyopathy

Year: 2024

Type: article

Abstract: BACKGROUND: Myocardial fibrosis (MF) forms part of the arrhythmic substrate for ventricular arrhythmias (VAs). OBJECTIVES: This study sought to determine whether total myocardial fibrosis (TF) and gray zone fibrosis (GZF), assessed using cardiovascular magnetic resonance, are better than left ventricular ejection fraction (LVEF) in predicting ventricular arrhythmias in patients with nonischemic cardiomyopathy (NICM). METHODS: Patients with NICM in a derivation cohort (n = 866) and a validation cohort (n = 848) underwent quantification of TF and GZF. The primary composite endpoint was sudden cardiac death or VAs (ventricular fibrillation or ventricular tachycardia). RESULTS: (lowest risk). Similar trends were observed in the validation cohort. Categorization into these 3 risk groups was achievable using TF or GZF in combination or in isolation. In contrast, LVEF of <35% was a poor predictor of the primary endpoint (validation cohort HR: 1.99; 95% CI: 0.99-4.01). CONCLUSIONS: . In contrast, LVEF was a poor discriminator of arrhythmic risk.

Source: Journal of the American College of Cardiology

DOI: 10.1016/j.jacc.2024.06.046