Prognostic value of cardiovascular magnetic resonance in patients with suspected arrhythmogenic right ventricular cardiomyopathy

Deac, Monica; Alpendurada, Francisco; Fanaie, Fariba; Raj, Vimal; Carpenter, John-Paul; Dawson, Adelle; Miller, Chris; Roussin, Isabelle; Pietro, Elisa Di; Ismail, Tevfik F; Roughton, Michael; Wong, Joyce; Dawson, Dana; Till, Janice; Sheppard, Mary N.; Mohiaddin, Raad H.; Kilner, Philip J.; Pennell, Dudley J.; Prasad, Sanjay K.

doi:10.1016/j.ijcard.2013.04.208

Cited by 51 publications

(27 citation statements)

References 33 publications

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“…This is consistent with a previous CMR study in a possible ARVD/C population, which correlated the extent of CMR imaging-measured RV abnormalities at baseline with adverse outcomes during follow-up. 37 Our preliminary observations advocate for a potential prominent role for echocardiography in the follow-up of patients with ARVD/ C. Minor LV involvement, measured by deformation imaging in the posterolateral region, has prognostic value that is superior to conventional measurements of RV and LV function. Moreover, the frequent use of ICDs in this population suits echocardiography more than CMR imaging for the follow-up of patients with ARVD/C.…”

Section: Discussionmentioning

confidence: 81%

Left Ventricular Involvement in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Assessed by Echocardiography Predicts Adverse Clinical Outcome

Mast

Teske

Heijden

et al. 2015

Journal of the American Society of Echocardiography

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Section: Discussionmentioning

confidence: 81%

Left Ventricular Involvement in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Assessed by Echocardiography Predicts Adverse Clinical Outcome

Mast

Teske

Heijden

et al. 2015

Journal of the American Society of Echocardiography

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“…2B) [78]. LGE-CMR findings were well correlated with histopathological findings and associated with RV dysfunction, inducible ventricular arrhythmia on electrophysiological testing [79] and adverse cardiac outcome [35]. Therefore, LGE-CMR may provide guidance for electrophysiological studies and endomyocardial biopsy in patients with suspected ARVD.…”

Section: Cviamentioning

confidence: 82%

“…In addition, CMR provides important prognostic information in patients with suspected ARVC. In a previous longitudinal study that followed 369 consecutive patients with at least one criterion for ARVC and defined abnormal CMR findings as increased RV volumes, reduced RV ejection fraction, RV regional wall motion abnormalities, myocardial fatty infiltration and myocardial fibrosis, patients with multiple abnormalities were at a greater risk of SCD, while patients without any of those abnormal findings had a very low event rate [35].…”

Section: Morphology and Function Assessment: Cine-cmrmentioning

confidence: 99%

Evaluation of Sudden Cardiac Death Risk Using Cardiac Magnetic Resonance

Choi

Yoon

2017

Cardiovasc Imaging Asia

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Sudden cardiac death (SCD) is not uncommon event worldwide. In a report from the Unites States, age-adjusted nationwide incidence of SCD was estimated at 60 per 100000 residents, and the public health burden of SCD is greater than individual cancer [1]. Moreover, the survival to discharge in out-of-hospital cardiac arrest is only 6.4% in patients who required emergency medical services [2]. To prevent this devastating consequence and improve survival, implantable cardioverter-defibrillator (ICD) is considered as the treatment of choice for patients who survive SCD or have a high risk of SCD. However, the decision whether to implant ICD is not straightforward. In a series of major trials, only 20−35% of patients experienced appropriate shock delivery in 1 to 3 years after ICD implantation [3]. Simultaneously, the cumulative incidence of inappropriate shock during 5 years of follow-up was 18%, which is associated with the increased risk of all-cause mortality [4]. In addition, in the pooled analysis of randomized clinical trials, 9.1% of patients experienced complications associated with ICD over 16 months [5]. Given the expense and risks of ICDs, accurately differentiating patients at higher risk of SCD is important.Based on current guidelines, ICD for primary prevention is recommended in symptomatic patients with left ventricular ejection fraction (LVEF) <35% who did not respond to medical treatment (Table 1) [6][7][8]. Therefore, to date, transthoracic echocardiography (TTE) has played a major role for identifying patients with severe left ventricular (LV) dysfunction and higher risk of SCD. However, the issue on the selection of patients for ICD implantation based on LVEF using TTE has been raised constantly [8,9]. First, although two-dimensional (2D) TTE remains the most commonly used technique for the measurement of LVEF, it is based on geometric assumptions and is often limited by the sonic window. Second, use of LVEF alone showed a lack of sensitivity and specificity for the prediction of SCD. Although patients with severe LV dysfunction were shown to be at higher risk, they constitute less than one third of SCD cases [10,11]. In many instances, SCDs occur as the first manifestation of heart disease or in patients with a heart disease but with no or mild LV systolic dysfunction [12]. In a community-based prospective study entitled Oregon Sudden Unexpected Death Study, only 20% of patients who experienced SCD were eligible for ICD implantation based on the current guidelines that included LVEF and symptoms [13].Recently, great technical advances and diminished scan times have been achieved in the field of cardiac magnetic resocc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/bync/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Sudden cardiac death (SCD) is a significant problem worldwide and the risk strati...

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“…A similar study on prognosis in patients under evaluation for ARVC reports a positive predictive value of an abnormal CMR in 369 patients who fulfilled at least one minor or major diagnostic criterion for ARVC. The negative predictive value of a normal CMR was 98.8% over a follow-up of 4.3AE1.5 years [78].…”

Section: Prevention Of Sudden Deathmentioning

confidence: 87%