Left Ventricular Midwall Fibrosis as a Predictor of Mortality and Morbidity After Cardiac Resynchronization Therapy in Patients With Nonischemic Cardiomyopathy

Leyva, Francisco; Taylor, Robin J.; Foley, Paul; Umar, Fraz; Mulligan, Lawrence J.; Patel, Kiran; Stegemann, Berthold; Haddad, Tarek; Smith, R. V.; Prasad, Sanjay

doi:10.1016/j.jacc.2012.05.054

Cited by 177 publications

(125 citation statements)

References 34 publications

(31 reference statements)

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“…The majority of studies evaluated the presence or absence of LGE by visual analysis. 4,6,7,10,[13][14][15][16][17][18][19][20]22,[24][25][26][27][28][29]30,32 Duration of follow-up ranged from 1 year to 5.3 years; mean follow up was 3 years. The majority of reports considered a composite arrhythmic end-point formed by sudden cardiac death and/or aborted cardiac arrest, sustained ventricular arrhythmias and/or appropriate ICD therapies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The majority of reports considered a composite arrhythmic end-point formed by sudden cardiac death and/or aborted cardiac arrest, sustained ventricular arrhythmias and/or appropriate ICD therapies. 4,5,7,8,10,13,14,[16][17][18]20,22,25,[28][29][30][31] In two reports history of arrhythmic events was the end-point analyzed. 9,32 These data were not used to calculate annual event rates, but were included in the evaluation of pooled OR.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Late Gadolinium Enhancement and the Risk for Ventricular Arrhythmias or Sudden Death in Dilated Cardiomyopathy

Marco

Anguera

Schmitt³

et al. 2017

JACC: Heart Failure

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296

188

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Di Marco, A. et al. (2017) Late gadolinium enhancement and the risk for ventricular arrhythmias or sudden death in dilated cardiomyopathy: systematic review and meta-analysis. JACC: Heart Failure, 5(1), pp. 28-38. (doi:10.1016/j.jchf.2016.09.017) This is the author's final accepted version.There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.http://eprints.gla.ac.uk/133553/ Background: Risk stratification for SCD in DCM needs to be improved.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Late Gadolinium Enhancement and the Risk for Ventricular Arrhythmias or Sudden Death in Dilated Cardiomyopathy

Marco

Anguera

Schmitt³

et al. 2017

JACC: Heart Failure

Self Cite

296

188

View full text Add to dashboard Cite

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“…(57,58) Published data revealed a discrepancy between clinical and echocardiographic responses, with more studies reporting clinical response than echocardiographic improvement. (59) Reduced response to CRT has been associated with a high myocardial scar burden, (60) posterolateral (61) and mid-wall (62) scar location, extreme mechanical dyssynchrony, (63) severe right ventricular dysfunction, pulmonary hypertension, end-stage renal failure, and valvular heart disease. On the other hand, better CRT outcomes have been reported in female patients (64,65) and those with non-ischaemic cardiomyopathy.…”

Section: Cardiac Resynchronisation Therapymentioning

confidence: 99%

“…On the other hand, better CRT outcomes have been reported in female patients (64,65) and those with non-ischaemic cardiomyopathy. (62) Efforts have been made to identify factors which may better predict response to CRT. The Predictors of Response to CRT trial (66) and EchoCRT study (54) revealed that echocardiographic measures of mechanical dyssynchrony did not reliably predict CRT response.…”

Section: Cardiac Resynchronisation Therapymentioning

confidence: 99%

Overview of implantable cardioverter defibrillator and cardiac resynchronisation therapy in heart failure management

Chia¹,

Foo²

2016

smedj

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Clinical trials have established the benefits of implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) in the treatment of heart failure patients. As adjuncts to guideline-directed medical therapy, ICDs confer mortality benefits from sudden cardiac arrest, while CRT reduces mortality, hospitalisation rates and improves functional capacity. This review discusses the use of ICDs and CRT devices in heart failure management, outlining the evidence supporting their use, indications and contraindications.

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“…In order to achieve a better selection, the existence of factors, which could predict the response to CRT has been extensively investigated [32][33][34][35]. Factors, like female gender [36][37][38] and non-ischemic etiology [38,39] are related to a positive response to CRT and, on the contrary, some comorbidities, like end-stage renal failure and pulmonary hypertension appear to diminish the response to CRT [38]. Also, QRS duration and LBBB correlate positively with CRT response [40][41][42].…”

Section: Imaging Predictive Factorsmentioning

confidence: 99%

Imaging predictive factors and exercise training in CRT patients

Abreu

Santa-Clara

2016

Monaldi Arch Chest Dis

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Cardiac resynchronization therapy (CRT) is an established treatment for patients with moderate-to-severe chronic heart failure (CHF) and intraventricular conduction delay, which is identified by a QRS interval of 120 msec or more on a 12-lead electrocardiogram (ECG). CRT improves functional capacity, reduced hospitalizations for worsening CHF and increased survival, however, about 30-40% of patients who undergo CRT are non-responders with no clinical or echocardiographic improvement. Imaging parameters for prediction of CRT response have been reviewed. Cardiac magnetic resonance (CMR), recognized as the gold standard to assess viability, has shown to obtain good results regarding quantification of scar burden. CMR-derived measures of mechanical dyssynchrony appear to predict the outcome of CRT, however these have not been externally validated. Nuclear imaging techniques, namely single-photon emission cardiac tomography (SPECT) provide data on scar burden and location, left ventricular (LV) function, LV contraction and mechanical dyssynchrony from a single scan. The presence, location and burden of myocardial scar have been shown to affect response to CRT. However, compared to CMR, the low spatial resolution of scintigraphy might overestimate the scar extent. This problem can be overcome by positron emission tomography (PET). SPECT has also been used to quantify dyssynchrony, using phase analysis. Imaging investigation is ongoing, trying to better identify CRT non-responders. The combination of ExT in CRT has not been well investigated, however some data show that different aerobic exercise modes and intensities can further improve CRT benefits. Data available on the effects of ExT in patients with CRT have been reviewed.

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Left Ventricular Midwall Fibrosis as a Predictor of Mortality and Morbidity After Cardiac Resynchronization Therapy in Patients With Nonischemic Cardiomyopathy

Abstract: Midwall fibrosis is an independent predictor of mortality and morbidity in patients with DCM undergoing CRT. The outcome of DCM with midwall fibrosis is similar to that of ICM. This relationship is mediated by both pump failure and sudden cardiac death.

Cited by 177 publications

References 34 publications

Late Gadolinium Enhancement and the Risk for Ventricular Arrhythmias or Sudden Death in Dilated Cardiomyopathy

Late Gadolinium Enhancement and the Risk for Ventricular Arrhythmias or Sudden Death in Dilated Cardiomyopathy

Overview of implantable cardioverter defibrillator and cardiac resynchronisation therapy in heart failure management

Imaging predictive factors and exercise training in CRT patients

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