Work

Prognostic value of late gadolinium enhancement cardiac MRI for ICD therapy in non-ischaemic cardiomyopathy

Year: 2025

Type: article

Abstract: AIM: To evaluate the impact of the 2023 Dutch national guidelines for primary prevention implantable cardioverter-defibrillator (ICD) implantation on outcomes in non-ischaemic cardiomyopathy (NICM) patients and to assess the role of late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR) in predicting ICD therapy. METHODS: This retrospective, single-centre observational exploratory cohort study included patients with NICM who received a primary prevention single-chamber, dual-chamber or subcutaneous ICD between January 2008 and April 2022 and underwent LGE-CMR prior to implantation. Patients were classified into LGE+ and LGE- groups based on the presence of late enhancement detected by CMR. The primary endpoint was time to first appropriate ICD therapy. The secondary endpoint was all-cause mortality. RESULTS: Of the 258 NICM patients in the database, a total of 85 patients were included, of whom 41 had LGE on CMR. After a 5-year follow-up period, appropriate ICD therapy occurred in 20% of the patients in the LGE+ group and 14% of patients in the LGE- group (p = 0.37). All-cause mortality was 7% in the LGE+ group and 14% in the LGE- group (p = 0.46). Multivariable analysis showed no parameters significantly associated with appropriate ICD therapy. CONCLUSION: Applying the 2023 national guidelines retrospectively on a population of NICM patients with a primary prevention ICD indication demonstrated no significant association between LGE on CMR and appropriate ICD therapy over a follow-up period of 5 years. These findings underscore the need for further research and randomised trials to refine risk stratification and ICD implantation guidelines in NICM, ideally leveraging a multicentre approach to address current limitations in sample size and enhance the generalisability of the results.

Source: Netherlands Heart Journal

DOI: 10.1007/s12471-025-01946-3

Authors: Luuk H. G. A. Hopman, Marthe A. J. Becker, Sanna H. M. de Haas, Anne-Lotte C. J. van der Lingen, Mischa T. Rijnierse, Pranav Bhagirath, Michiel J. J. M. Zumbrink, Louise R. A. Olde Nordkamp, Lourens F. H. J. Robbers, Marco J. W. Götte, Vokko P. van Halm, Cornelis P. Allaart

Institutions: Amsterdam UMC Location University of Amsterdam, Amsterdam University Medical Centers, Jeroen Bosch Ziekenhuis

Language: English

Topic: Cardiac pacing and defibrillation studies

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4408884654

FWCI: 1.257

Cites: 29

Cited by: 2

Related to: 10