Risk Assessment of Ventricular Arrhythmias in Patients with Nonischemic Dilated Cardiomyopathy by Strain Echocardiography

Haugaa, Kristina H.; Goebel, Björn; Dahlslett, Thomas; Meyer, Kathleen; Jung, Christian; Lauten, Alexander; Figulla, Hans R.; Poerner, Tudor C.; Edvardsen, Thor

doi:10.1016/j.echo.2012.02.004

Cited by 157 publications

(103 citation statements)

References 39 publications

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“…8 In addition, a heterogeneous myocardial contraction pattern determined by a dyssynchronic ventricular contraction (known as MD or dyssynchrony) has also been demonstrated useful to predict ventricular arrhythmias. 6,7 In contrast to previous studies, [24][25][26] we did not find MD to be a strong predictor of ventricular tachyarrhythmias (Table 2). This might be because of the fact that we only obtained MD from 12 segments (apical 4-and 2-chamber views) instead of 18 segments or because 2DSE was performed on Digital Imaging and Communications in Medicine images leading to lower frame rates than used in previous studies.…”

Section: Myocardial Deformation and Prognosiscontrasting

confidence: 56%

Regional Longitudinal Deformation Improves Prediction of Ventricular Tachyarrhythmias in Patients With Heart Failure With Reduced Ejection Fraction

Knappe

Pouleur

Claggett

et al. 2017

Circ: Cardiovascular Imaging

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Background— Left ventricular dysfunction is a known predictor of ventricular arrhythmias. We hypothesized that measures of regional longitudinal deformation by speckle-tracking echocardiography predict ventricular tachyarrhythmias and provide incremental prognostic information over clinical and conventional echocardiographic characteristics. Methods and Results— We studied 1064 patients enrolled in the MADIT-CRT trial (Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy) with speckle-tracking data available. Peak longitudinal strain was obtained for the septal, lateral, anterior, and inferior myocardial walls at baseline. The end point was the first event of ventricular tachycardia (VT) or fibrillation (VF). During the median follow-up of 2.9 years, 254 (24%) patients developed VT/VF. Patients with VT/VF had significantly lower left ventricular ejection fraction (28.3% versus 29.5%; P <0.001) and longitudinal strain in all myocardial walls compared with patients without VT/VF (anterior-strain, −7.7% versus −8.8%; P <0.001; lateral-strain, −7.3% versus −7.9%; P =0.022; inferior-strain, −8.3% versus −9.9%; P <0.001; septal-strain, −9.1% versus −10.0%; P <0.001). After multivariate adjustment, only anterior and inferior longitudinal strain remained independent predictors of VT/VF (anterior: hazard ratio, 1.08 [1.03–1.13]; P =0.001; inferior: hazard ratio, 1.08 [1.04–1.12]; P <0.001; per 1% absolute decrease for both). When including B-type natriuretic peptide in the model, only a decreasing myocardial function in the inferior myocardial wall predicted VT/VF (hazard ratio, 1.05 [1.00–1.11]; P =0.039). Only strain obtained from the inferior myocardial wall provided incremental prognostic information for VT/VF over clinical and echocardiographic parameters (C statistic 0.71 versus 0.69; P =0.005). Conclusions— Assessment of regional longitudinal myocardial deformation in the inferior region provided incremental prognostic information over clinical and echocardiographic risk factors in predicting ventricular tachyarrhythmias. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00180271.

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Section: Myocardial Deformation and Prognosiscontrasting

confidence: 56%

Regional Longitudinal Deformation Improves Prediction of Ventricular Tachyarrhythmias in Patients With Heart Failure With Reduced Ejection Fraction

Knappe

Pouleur

Claggett

et al. 2017

Circ: Cardiovascular Imaging

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“…Left ventricular function in patients with DCM is closely related to the occurrence of severe ventricular arrhythmias (Haugaa et al, 2012). Dilated left ventricle has a larger left atrial appendage and seems to be at a higher risk for thrombus formation (Bakalli et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Torasemide reduces dilated cardiomyopathy, complication of arrhythmia, and progression to heart failure

Han¹,

Guo²,

Lin³

et al. 2014

Genet. Mol. Res.

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ABSTRACT. The aim of this study was to analyze the incidence and types of arrhythmia and their relationship with the severity and prognosis of chronic heart failure (CHF) in patients with dilated cardiomyopathy (DCM), and to investigate the therapeutic effect of torasemide versus furosemide on CHF and incidence of arrhythmia. DCM patients with NYHA cardiac function II-IV were continuously monitored using a 24-h dynamic electrocardiogram (Holter), and arrhythmia incidence was analyzed by computer automatic analysis combined with manual assessment. In total, 125 participants were evenly divided into two groups: torasemide group which received 10 mg oral torasemide once daily) and regular anti-heart failure treatment (N = 65), and furosemide group which received torasemide (20 mg once daily orally) and regular antiheart failure treatment (N = 60). Another 60 normal healthy persons served as the normal control group. Incidence and severity of arrhythmia increased when degree of CHF was elevated. Size of left atrium was related to atrial fibrillation and size of left ventricle was related to malignant arrhythmia. At 3 months after treatment, cardiac function in both groups improved and incidence and severity of arrhythmia in both groups were reduced. However, left ventricular ejection fraction (LVEF) was higher in the torasemide group than in the furosemide group, while incidence of arrhythmia was lower in the torasemide group. Arrhythmias frequently occurred in patients with DCM and HF. Type of cardiac arrhythmia is closely related to ventricular enlargement and cardiac function grade. Torasemide is better for improving cardiac function to reduce arrhythmia and CHF compared to furosemide.

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“…Prior studies in patients with LV myocardial infarction and cardiomyopathies with reduced ventricular function (Ersbøll et al 2013a(Ersbøll et al , 2013bHaugaa et al 2010bHaugaa et al , 2012Haugaa et al , 2013Sarvari et al 2011) found that global longitudinal strain and mechanical dispersion are promising markers of arrhythmias and predicted arrhythmic events independently of LVEF.…”

Section: Introductionmentioning

confidence: 98%

Global and Regional Left Ventricular Strain Indices in Post-Myocardial Infarction Patients with Ventricular Arrhythmias and Moderately Abnormal Ejection Fraction

Nguyen

Capotosto

Persi

et al. 2015

Ultrasound in Medicine & Biology

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Risk Assessment of Ventricular Arrhythmias in Patients with Nonischemic Dilated Cardiomyopathy by Strain Echocardiography

Cited by 157 publications

References 39 publications

Regional Longitudinal Deformation Improves Prediction of Ventricular Tachyarrhythmias in Patients With Heart Failure With Reduced Ejection Fraction

Regional Longitudinal Deformation Improves Prediction of Ventricular Tachyarrhythmias in Patients With Heart Failure With Reduced Ejection Fraction

Torasemide reduces dilated cardiomyopathy, complication of arrhythmia, and progression to heart failure

Global and Regional Left Ventricular Strain Indices in Post-Myocardial Infarction Patients with Ventricular Arrhythmias and Moderately Abnormal Ejection Fraction

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