Reply to: Letter to the Editor regarding ‘Cardiac magnetic resonance for prophylactic implantable-cardioverter defibrillator therapy international study: prognostic value of cardiac magnetic resonance-derived right ventricular parameters substudy’

Al’Aref, Subhi J.; Malkawi, Abdallah

doi:10.1093/ehjci/jeac169

Cited by 7 publications

(4 citation statements)

References 4 publications

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“…A prior article used the entire DERIVATE cohort (n = 2449), thereby including the 761 participants of the current study. This prior analysis dealt with the predictive power of right ventricular functional parameters for all-cause mortality and a composite of heart failure hospitalization and/or all-cause mortality (18).…”

Section: Key Resultsmentioning

confidence: 99%

AI Cardiac MRI Scar Analysis Aids Prediction of Major Arrhythmic Events in the Multicenter DERIVATE Registry

Ghanbari¹,

Joyce²,

Lorenzoni³

et al. 2023

Radiology

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Background: Scar burden with late gadolinium enhancement (LGE) cardiac MRI (CMR) predicts arrhythmic events in patients with postinfarction in single-center studies. However, LGE analysis requires experienced human observers, is time consuming, and introduces variability.Purpose: To test whether postinfarct scar with LGE CMR can be quantified fully automatically by machines and to compare the ability of LGE CMR scar analyzed by humans and machines to predict arrhythmic events. Materials and Methods:This study is a retrospective analysis of the multicenter, multivendor CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy (DERIVATE) registry. Patients with chronic heart failure, echocardiographic left ventricular ejection fraction (LVEF) of less than 50%, and LGE CMR were recruited (from January 2015 through December 2020). In the current study, only patients with ischemic cardiomyopathy were included. Quantification of total, dense, and nondense scars was carried out by two experienced readers or a Ternaus network, trained and tested with LGE images of 515 and 246 patients, respectively. Univariable and multivariable Cox analyses were used to assess patient and cardiac characteristics associated with a major adverse cardiac event (MACE). Area under the receiver operating characteristic curve (AUC) was used to compare model performances. Results:In 761 patients (mean age, 65 years ± 11, 671 men), 83 MACEs occurred. With use of the testing group, univariable Coxanalysis found New York Heart Association class, left ventricle volume and/or function parameters (by echocardiography or CMR), guideline criterion (LVEF of ≤35% and New York Heart Association class II or III), and LGE scar analyzed by humans or the machinelearning algorithm as predictors of MACE. Machine-based dense or total scar conferred incremental value over the guideline criterion for the association with MACE (AUC: 0.68 vs 0.63, P = .02 and AUC: 0.67 vs 0.63, P = .01, respectively). Modeling with competing risks yielded for dense and total scar (AUC: 0.67 vs 0.61, P = .01 and AUC: 0.66 vs 0.61, P = .005, respectively). Conclusion:In this analysis of the multicenter CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy (DERIVATE) registry, fully automatic machine learning-based late gadolinium enhancement analysis reliably quantifies myocardial scar mass and improves the current prediction model that uses guideline-based risk criteria for implantable cardioverter defibrillator implantation.ClinicalTrials.gov registration no.: NCT03352648 Published under a CC BY 4.0 license.

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Section: Key Resultsmentioning

confidence: 99%

AI Cardiac MRI Scar Analysis Aids Prediction of Major Arrhythmic Events in the Multicenter DERIVATE Registry

Ghanbari¹,

Joyce²,

Lorenzoni³

et al. 2023

Radiology

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“…In patients with ischemic cardiomyopathy (ICM), CMR LVEF measurement is known to be related to MACE, but also CMR right ventricular ejection fraction (RVEF) has been demonstrated as an independent predictor of adverse events, highlighting the central role of CMR in the measurement of volumes and ejection fraction 18 …”

Section: Volumes and Functionmentioning

confidence: 99%

Cardiac magnetic resonance in advanced heart failure

Coraducci,

De Zan,

Fedele

et al. 2024

Echocardiography

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Heart failure (HF) is a chronic and progressive disease that often progresses to an advanced stage where conventional therapy is insufficient to relieve patients' symptoms. Despite the availability of advanced therapies such as mechanical circulatory support or heart transplantation, the complexity of defining advanced HF, which requires multiple parameters and multimodality assessment, often leads to delays in referral to dedicated specialists with the result of a worsening prognosis. In this review, we aim to explore the role of cardiac magnetic resonance (CMR) in advanced HF by showing how CMR is useful at every step in managing these patients: from diagnosis to prognostic stratification, hemodynamic evaluation, follow‐up and advanced therapies such as heart transplantation. The technical challenges of scanning advanced HF patients, which often require troubleshooting of intracardiac devices and dedicated scans, will be also discussed.

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“…To date, late gadolinium enhancement sequences are the most studied in the field of magnetic resonance, and its prognostic power has been demonstrated in numerous contexts of the cardiovascular field [ 134 , 135 , 136 ]. The evaluation of LGE using CMR in the acute setting could be important in terms of risk stratification of acute events, but also as sequelae of myocardial infarction [ 137 , 138 ].…”

Section: Late Gadolinium Enhancementmentioning

confidence: 99%

Multimodality Imaging of Sudden Cardiac Death and Acute Complications in Acute Coronary Syndrome

Muscogiuri

Guaricci

Soldato

et al. 2022

JCM

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Sudden cardiac death (SCD) is a potentially fatal event usually caused by a cardiac arrhythmia, which is often the result of coronary artery disease (CAD). Up to 80% of patients suffering from SCD have concomitant CAD. Arrhythmic complications may occur in patients with acute coronary syndrome (ACS) before admission, during revascularization procedures, and in hospital intensive care monitoring. In addition, about 20% of patients who survive cardiac arrest develop a transmural myocardial infarction (MI). Prevention of ACS can be evaluated in selected patients using cardiac computed tomography angiography (CCTA), while diagnosis can be depicted using electrocardiography (ECG), and complications can be evaluated with cardiac magnetic resonance (CMR) and echocardiography. CCTA can evaluate plaque, burden of disease, stenosis, and adverse plaque characteristics, in patients with chest pain. ECG and echocardiography are the first-line tests for ACS and are affordable and useful for diagnosis. CMR can evaluate function and the presence of complications after ACS, such as development of ventricular thrombus and presence of myocardial tissue characterization abnormalities that can be the substrate of ventricular arrhythmias.

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Reply to: Letter to the Editor regarding ‘Cardiac magnetic resonance for prophylactic implantable-cardioverter defibrillator therapy international study: prognostic value of cardiac magnetic resonance-derived right ventricular parameters substudy’

Cited by 7 publications

References 4 publications

AI Cardiac MRI Scar Analysis Aids Prediction of Major Arrhythmic Events in the Multicenter DERIVATE Registry

AI Cardiac MRI Scar Analysis Aids Prediction of Major Arrhythmic Events in the Multicenter DERIVATE Registry

Cardiac magnetic resonance in advanced heart failure

Multimodality Imaging of Sudden Cardiac Death and Acute Complications in Acute Coronary Syndrome

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