Late Gadolinium Enhancement and the Risk for Ventricular Arrhythmias or Sudden Death in Dilated Cardiomyopathy: Systematic Review and Meta-Analysis.

Détails

ID Serval
serval:BIB_21E8B318271C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Late Gadolinium Enhancement and the Risk for Ventricular Arrhythmias or Sudden Death in Dilated Cardiomyopathy: Systematic Review and Meta-Analysis.
Périodique
JACC. Heart failure
Auteur(s)
Di Marco A., Anguera I., Schmitt M., Klem I., Neilan T.G., White J.A., Sramko M., Masci P.G., Barison A., Mckenna P., Mordi I., Haugaa K.H., Leyva F., Rodriguez Capitán J., Satoh H., Nabeta T., Dallaglio P.D., Campbell N.G., Sabaté X., Cequier Á.
ISSN
2213-1787 (Electronic)
ISSN-L
2213-1779
Statut éditorial
Publié
Date de publication
01/2017
Peer-reviewed
Oui
Volume
5
Numéro
1
Pages
28-38
Langue
anglais
Notes
Publication types: Journal Article ; Meta-Analysis ; Review
Publication Status: ppublish
Résumé
The aim of this study was to evaluate the association between late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging and ventricular arrhythmias or sudden cardiac death (SCD) in patients with dilated cardiomyopathy (DCM).
Risk stratification for SCD in DCM needs to be improved.
A systematic review and meta-analysis were conducted. A systematic search of PubMed and Ovid was performed, and observational studies that analyzed the arrhythmic endpoint (sustained ventricular arrhythmia, appropriate implantable cardioverter-defibrillator [ICD] therapy, or SCD) in patients with DCM, stratified by the presence or absence of LGE, were included.
Twenty-nine studies were included, accounting for 2,948 patients. The studies covered a wide spectrum of DCM, with a mean left ventricular ejection fraction between 20% and 43%. LGE was significantly associated with the arrhythmic endpoint both in the overall population (odds ratio: 4.3; p < 0.001) and when including only those studies that performed multivariate analysis (hazard ratio: 6.7; p < 0.001). The association between LGE and the arrhythmic endpoint remained significant among studies with mean left ventricular ejection fractions >35% (odds ratio: 5.2; p < 0.001) and was maximal in studies that included only patients with primary prevention ICDs (odds ratio: 7.8; p = 0.008).
Across a wide spectrum of patients with DCM, LGE is strongly and independently associated with ventricular arrhythmia or SCD. LGE could be a powerful tool to improve risk stratification for SCD in patients with DCM. These results raise 2 major questions to be addressed in future studies: whether patients with LGE could benefit from primary prevention ICDs irrespective of their left ventricular ejection fractions, while patients without LGE might not need preventive ICDs despite having severe left ventricular dysfunction.

Mots-clé
Arrhythmias, Cardiac/etiology, Cardiomyopathy, Dilated/complications, Cardiomyopathy, Dilated/diagnostic imaging, Contrast Media, Death, Sudden, Cardiac/etiology, Gadolinium, Humans, Magnetic Resonance Imaging, cardiac magnetic resonance, dilated cardiomyopathy, late gadolinium enhancement, sudden death, ventricular arrhythmias
Pubmed
Web of science
Création de la notice
03/01/2017 20:10
Dernière modification de la notice
20/08/2019 13:58
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