For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
0
views
19
references
 Top references
cited by
10
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      211
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Left ventricular midwall fibrosis as a predictor of sudden cardiac death in non‐ischaemic dilated cardiomyopathy: a meta‐analysis

      review-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Identification of patients with non‐ischaemic dilated cardiomyopathy (NICM) who are at risk of sudden cardiac death (SCD) and could benefit from an implantable cardioverter defibrillator (ICD) is challenging. The study aims to systematically assess the prognostic value of left ventricular (LV) midwall late gadolinium enhancement (LGE) pattern in patients with NICM and further explore its value on predicting SCD events. The study was prospectively registered in PROPSERO (CRD42019138468). We systematically searched PubMed, Ovid Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov to identify studies that evaluated the association between LV midwall LGE and clinical outcomes (all‐cause mortality, cardiovascular mortality, and SCD or aborted SCD endpoint) in NICM patients. A meta‐analysis was performed to determine pooled odds ratio (OR) for these adverse events. Seven studies including 1827 NICM patients over a mean follow‐up duration of 36.1 ± 19.3 months were included. The presence of LV midwall LGE pattern was observed in 562 (30.8%) patients. The pooled OR was 3.37 [95% confidence intervals (CIs): 1.35–8.42] for all‐cause mortality, 5.56 (95% CI: 1.23–25.22) for cardiovascular mortality, and 2.25 (95% CI: 1.16–3.16) for SCD or aborted SCD. In a subgroup analysis with mean ejection fraction cut‐off point of 35%, the pooled OR for SCD or aborted SCD was 2.06 (95% CI: 1.32–3.22) for LV ejection fraction (LVEF) > 35% and 2.49 (95% CI: 1.48–4.20) for LVEF ≤ 35%. In addition, our study indicated that LV midwall LGE showed an excellent negative predictive value in identifying high‐risk NICM patients and that the number needed to treat with ICD implantation in NICM patients with midwall LGE is 7. The presence of LV midwall on LGE is a significant prognosticator of adverse events in NICM patients. Additionally, patients with LV midwall LGE may be considered for ICD therapy irrespective of LVEF.

          Related collections

          Most cited references19

          • Record: found
          • Abstract: found
          • Article: not found

          Association of fibrosis with mortality and sudden cardiac death in patients with nonischemic dilated cardiomyopathy.

          Ankur Gulati, Andrew Jabbour, Tevfik Ismail … (2013)
          Risk stratification of patients with nonischemic dilated cardiomyopathy is primarily based on left ventricular ejection fraction (LVEF). Superior prognostic factors may improve patient selection for implantable cardioverter-defibrillators (ICDs) and other management decisions. To determine whether myocardial fibrosis (detected by late gadolinium enhancement cardiovascular magnetic resonance [LGE-CMR] imaging) is an independent and incremental predictor of mortality and sudden cardiac death (SCD) in dilated cardiomyopathy. Prospective, longitudinal study of 472 patients with dilated cardiomyopathy referred to a UK center for CMR imaging between November 2000 and December 2008 after presence and extent of midwall replacement fibrosis were determined. Patients were followed up through December 2011. Primary end point was all-cause mortality. Secondary end points included cardiovascular mortality or cardiac transplantation; an arrhythmic composite of SCD or aborted SCD (appropriate ICD shock, nonfatal ventricular fibrillation, or sustained ventricular tachycardia); and a composite of HF death, HF hospitalization, or cardiac transplantation. Among the 142 patients with midwall fibrosis, there were 38 deaths (26.8%) vs 35 deaths (10.6%) among the 330 patients without fibrosis (hazard ratio [HR], 2.96 [95% CI, 1.87-4.69]; absolute risk difference, 16.2% [95% CI, 8.2%-24.2%]; P < .001) during a median follow-up of 5.3 years (2557 patient-years of follow-up). The arrhythmic composite was reached by 42 patients with fibrosis (29.6%) and 23 patients without fibrosis (7.0%) (HR, 5.24 [95% CI, 3.15-8.72]; absolute risk difference, 22.6% [95% CI, 14.6%-30.6%]; P < .001). After adjustment for LVEF and other conventional prognostic factors, both the presence of fibrosis (HR, 2.43 [95% CI, 1.50-3.92]; P < .001) and the extent (HR, 1.11 [95% CI, 1.06-1.16]; P < .001) were independently and incrementally associated with all-cause mortality. Fibrosis was also independently associated with cardiovascular mortality or cardiac transplantation (by fibrosis presence: HR, 3.22 [95% CI, 1.95-5.31], P < .001; and by fibrosis extent: HR, 1.15 [95% CI, 1.10-1.20], P < .001), SCD or aborted SCD (by fibrosis presence: HR, 4.61 [95% CI, 2.75-7.74], P < .001; and by fibrosis extent: HR, 1.10 [95% CI, 1.05-1.16], P < .001), and the HF composite (by fibrosis presence: HR, 1.62 [95% CI, 1.00-2.61], P = .049; and by fibrosis extent: HR, 1.08 [95% CI, 1.04-1.13], P < .001). Addition of fibrosis to LVEF significantly improved risk reclassification for all-cause mortality and the SCD composite (net reclassification improvement: 0.26 [95% CI, 0.11-0.41]; P = .001 and 0.29 [95% CI, 0.11-0.48]; P = .002, respectively). Assessment of midwall fibrosis with LGE-CMR imaging provided independent prognostic information beyond LVEF in patients with nonischemic dilated cardiomyopathy. The role of LGE-CMR in the risk stratification of dilated cardiomyopathy requires further investigation.
          Article 0 comments Cited 351 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Cardiovascular magnetic resonance, fibrosis, and prognosis in dilated cardiomyopathy.

            Ravi G Assomull, Sanjay Prasad, Jonathan C. Lyne … (2006)
            We studied the prognostic implications of midwall fibrosis in dilated cardiomyopathy (DCM) in a prospective longitudinal study. Risk stratification of patients with nonischemic DCM in the era of device implantation is problematic. Approximately 30% of patients with DCM have midwall fibrosis as detected by late gadolinium-enhancement (LGE) cardiovascular magnetic resonance (CMR), which may increase susceptibility to arrhythmia and progression of heart failure. Consecutive DCM patients (n = 101) with the presence or absence of midwall fibrosis were followed up prospectively for 658 +/- 355 days for events. Midwall fibrosis was present in 35% of patients and was associated with a higher rate of the predefined primary combined end point of all-cause death and hospitalization for a cardiovascular event (hazard ratio 3.4, p = 0.01). Multivariate analysis showed midwall fibrosis as the sole significant predictor of death or hospitalization. However, there was no significant difference in all-cause mortality between the 2 groups. Midwall fibrosis also predicted secondary outcome measures of sudden cardiac death (SCD) or ventricular tachycardia (VT) (hazard ratio 5.2, p = 0.03). Midwall fibrosis remained predictive of SCD/VT after correction for baseline differences in left ventricular ejection fraction between the 2 groups. In DCM, midwall fibrosis determined by CMR is a predictor of the combined end point of all-cause mortality and cardiovascular hospitalization, which is independent of ventricular remodeling. In addition, midwall fibrosis by CMR predicts SCD/VT. This suggests a potential role for CMR in the risk stratification of patients with DCM, which may have value in determining the need for device therapy.
            Article 0 comments Cited 243 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Population-based analysis of sudden cardiac death with and without left ventricular systolic dysfunction: two-year findings from the Oregon Sudden Unexpected Death Study.

              Eric Stecker, Justin Waltz, Jonathan Jui … (2006)
              We sought to evaluate the contribution of left ventricular (LV) dysfunction toward occurrence of sudden cardiac death (SCD) in the general population, and to identify distinguishing characteristics of SCD in the absence of LV dysfunction. Patients who manifest warning symptoms and signs are more likely to undergo evaluation before SCD. Although prevalence of LV dysfunction in this subgroup may overestimate the prevalence in overall SCD, this is the only means of assessment in the general population. All cases of SCD in Multnomah County, Oregon (population 660,486; 2002 to 2004) were prospectively ascertained in the ongoing Oregon Sudden Unexpected Death Study. We retrospectively assessed LV ejection fraction (LVEF) among subjects who underwent evaluation of LV function before SCD (normal: > or =55%; mildly to moderately reduced: 36% to 54%; and severely reduced: < or =35%). Of a total of 714 SCD cases (annual incidence 54 per 100,000), LV function was assessed in 121 (17%). The LVEF was severely reduced in 36 patients (30%), mildly to moderately reduced in 27 (22%), and normal in 58 (48%). Patients with normal LVEF were distinguishable by younger age (66 +/- 15 years vs. 74 +/- 10 years; p = 0.001), higher proportion of females (47% vs. 27%; p = 0.025), higher prevalence of seizure disorder (14% vs. 0%; p = 0.002), and lower prevalence of established coronary artery disease (50% vs. 81%; p < 0.001). In this community-wide study, only one-third of the evaluated SCD cases had severe LV dysfunction meeting current criteria for prophylactic cardioverter-defibrillator implantation. The SCD cases with normal LV function had several distinguishing clinical characteristics. These findings support the aggressive development of alternative screening methods to enhance identification of patients at risk.
              Article 0 comments Cited 119 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Yucheng Chen: chenyucheng2003@163.com
                Journal
                Journal ID (nlm-ta): ESC Heart Fail
                Journal ID (iso-abbrev): ESC Heart Fail
                Journal ID (doi): 10.1002/(ISSN)2055-5822
                Journal ID (publisher-id): EHF2
                Title: ESC Heart Failure
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2055-5822
                Publication date (Electronic): 30 June 2020
                Publication date Collection: October 2020
                Volume: 7
                Issue: 5 ( doiID: 10.1002/ehf2.v7.5 )
                Pages: 2184-2192
                Affiliations
                [ 1 ] Department of Cardiology, West China Hospital Sichuan University Guoxue Xiang No. 37 Chengdu Sichuan 610041 China
                [ 2 ] Department of Cardiology, Rare Disease Center, West China Hospital Sichuan University Chengdu China
                [ 3 ] Department of Geriatrics, West China Hospital Sichuan University Chengdu China
                [ 4 ] Institute of Cancer and Genomic Sciences University of Birmingham Birmingham UK
                [ 5 ] Department of Medicine (Cardiovascular Division) University of Pennsylvania Philadelphia PA USA
                Author notes
                [*] [* ]Correspondence to: Yucheng Chen, Department of Cardiology, West China Hospital, Sichuan University, Guoxue Xiang No. 37, Chengdu, Sichuan 610041, China. Tel: 86‐18980602149; Fax: 86‐028‐85422836. Email: chenyucheng2003@ 123456163.com .
                Article
                Publisher ID: EHF212865 Other ID: ESCHF-19-00329
                DOI: 10.1002/ehf2.12865
                PMC ID: 7524301
                PubMed ID: 32603034
                SO-VID: 8119f92f-af4e-4ef3-b15a-edefd2b8dd76
                Copyright © © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Date received : 17 October 2019
                Date revision received : 26 May 2020
                Date accepted : 09 June 2020
                Page count
                Figures: 4, Tables: 4, Pages: 9, Words: 3825
                Funding
                Funded by: Sichuan province science and technology support grant, China
                Award ID: 2012JZ0002
                Funded by: 1·3·5 project for disciplines of excellence, West China Hospital, Sichuan University
                Award ID: ZYJC18013
                Funded by: China Scholarship Council , open-funder-registry 10.13039/501100004543;
                Categories
                Subject: Review
                Subject: Reviews
                Custom metadata
                source-schema-version-number 2.0
                cover-date October 2020
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.1 mode:remove_FC converted:29.09.2020

                Keywords: late gadolinium enhancement (lge),midwall,dilated cardiomyopathy,meta‐analysis
                Data availability:
                Keywords: late gadolinium enhancement (lge), midwall, dilated cardiomyopathy, meta‐analysis

                Comments

                Comment on this article

                scite_

                Similar content211

                See all similar

                Cited by10

                See all cited by

                Most referenced authors846

                See all reference authors