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Late gadolinium enhancement by magnetic resonance explains adverse cardiac events in individuals with ventricular arrhythmia; Realce tardío con gadolinio por resonancia magnética explica eventos cardíacos adversos en individuos con arritmia ventricular

Abstract

Objective: To determine whether the presence of late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR) predict adverse cardiac events in patients with ventricular arrhythmia. Methods: We selected 74 consecutive patients with symptomatic ventricular arrhythmia (premature ventricular contractions and ventricular tachycardia) and left ventricular ejection fraction (LVEF) >55% sent to CMR for evaluation of structural heart disease previously undetected by other complementary methods. LGE, systolic function and volumes of both ventricles were analyzed. At follow-up was assessed a combined end point: hospitalization for ventricular arrhythmia, appropriate implantable cardioverter-defibrillator therapy and cardiac death. Results: During a median follow up of 575 days (interquartile range 24-1120 days) and by analyzing the population according to the presence (n=9, 12%) or not (n=65, 88%) LGE was observed that the group with positive Gd had lower LVEF (58% vs. 66% respectively, p=0.01) and larger volumes (EDV: 185 ml vs. 123 ml respectively, p=0.01 and ESV: 81 ml vs. 42 ml respectively, p=0.01) than the other group. Two (22%) patients in the LGE + group vs. one (4%) of those without LGE showed the combined endpoint (p=0.01) and when performing a logistic regression analysis it was found that the LGE is a predictor of adverse cardiac  More>>
Authors:
Courtis, J.; Vasallo, J.; Arabia, L.; [1]  Dimitroff, M.; Gonzalez, A.; [2]  Tibaldi, M., E-mail: javiercourtis@oulton.com.ar [3] 
  1. Departamento de Imágenes, Cardiología Intervencionista y Electrofisiología Instituto Oulton, Córdoba (Argentina)
  2. Facultad de Ciencias Exactas, Físicas y Naturales, Universidad Nacional de Córdoba, Códoba (Argentina)
  3. Técnicas no Invasivas y Arritmias, Instituto Modelo de Cardiología, Córdoba (Argentina)
Publication Date:
Jul 01, 2012
Product Type:
Journal Article
Resource Relation:
Journal Name: Revista de la Federacion Argentina de Cardiologia; Journal Volume: 41; Journal Issue: 3; Other Information: 16 refs., 3 tabs., 2 figs.
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; GADOLINIUM; MAGNETIC RESONANCE; PATIENTS
OSTI ID:
22331387
Country of Origin:
Argentina
Language:
Spanish
Other Identifying Numbers:
Journal ID: ISSN 0326-646X; TRN: AR15A0199037671
Availability:
Also available at: http://www.fac.org.ar/1/revista/12v41n3/art_orig/arorig01/courtis.pdf
Submitting Site:
INIS
Size:
page(s) 171-177
Announcement Date:
May 13, 2015

Citation Formats

Courtis, J., Vasallo, J., Arabia, L., Dimitroff, M., Gonzalez, A., and Tibaldi, M., E-mail: javiercourtis@oulton.com.ar. Late gadolinium enhancement by magnetic resonance explains adverse cardiac events in individuals with ventricular arrhythmia; Realce tardío con gadolinio por resonancia magnética explica eventos cardíacos adversos en individuos con arritmia ventricular. Argentina: N. p., 2012. Web.
Courtis, J., Vasallo, J., Arabia, L., Dimitroff, M., Gonzalez, A., & Tibaldi, M., E-mail: javiercourtis@oulton.com.ar. Late gadolinium enhancement by magnetic resonance explains adverse cardiac events in individuals with ventricular arrhythmia; Realce tardío con gadolinio por resonancia magnética explica eventos cardíacos adversos en individuos con arritmia ventricular. Argentina.
Courtis, J., Vasallo, J., Arabia, L., Dimitroff, M., Gonzalez, A., and Tibaldi, M., E-mail: javiercourtis@oulton.com.ar. 2012. "Late gadolinium enhancement by magnetic resonance explains adverse cardiac events in individuals with ventricular arrhythmia; Realce tardío con gadolinio por resonancia magnética explica eventos cardíacos adversos en individuos con arritmia ventricular." Argentina.
@misc{etde_22331387,
title = {Late gadolinium enhancement by magnetic resonance explains adverse cardiac events in individuals with ventricular arrhythmia; Realce tardío con gadolinio por resonancia magnética explica eventos cardíacos adversos en individuos con arritmia ventricular}
author = {Courtis, J., Vasallo, J., Arabia, L., Dimitroff, M., Gonzalez, A., and Tibaldi, M., E-mail: javiercourtis@oulton.com.ar}
abstractNote = {Objective: To determine whether the presence of late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR) predict adverse cardiac events in patients with ventricular arrhythmia. Methods: We selected 74 consecutive patients with symptomatic ventricular arrhythmia (premature ventricular contractions and ventricular tachycardia) and left ventricular ejection fraction (LVEF) >55% sent to CMR for evaluation of structural heart disease previously undetected by other complementary methods. LGE, systolic function and volumes of both ventricles were analyzed. At follow-up was assessed a combined end point: hospitalization for ventricular arrhythmia, appropriate implantable cardioverter-defibrillator therapy and cardiac death. Results: During a median follow up of 575 days (interquartile range 24-1120 days) and by analyzing the population according to the presence (n=9, 12%) or not (n=65, 88%) LGE was observed that the group with positive Gd had lower LVEF (58% vs. 66% respectively, p=0.01) and larger volumes (EDV: 185 ml vs. 123 ml respectively, p=0.01 and ESV: 81 ml vs. 42 ml respectively, p=0.01) than the other group. Two (22%) patients in the LGE + group vs. one (4%) of those without LGE showed the combined endpoint (p=0.01) and when performing a logistic regression analysis it was found that the LGE is a predictor of adverse cardiac events analyzed (p=0.029). Conclusions: In this consecutive series of patients with ventricular arrhythmia we demonstrate a strong association between myocardial LGE and adverse cardiac events; this supports the hypothesis that myocardial fibrosis is an important arrhythmogenic substrate. In addition, almost all individuals without LGE were free of events during follow-up suggesting that it is possible to identify through the CMR low-risk individuals who can be treated conservatively. (authors) [Spanish] Objetivo: determinar si la presencia de realce tardío con gadolinio (RTG) por resonancia magnética cardiovascular (RMC) predice eventos cardíacos adversos en pacientes con arritmia ventricular. Métodos: se seleccionaron 74 pacientes consecutivos con arritmia ventricular sintomática (extrasístoles ventriculares y taquicardia ventricular) y fracción de eyección del ventrículo izquierdo (FEVI) >55% enviados a RMC para evaluación de cardiopatía estructural no detectada previamente por otros métodos complementarios. Se analizó el RTG, la función sistólica y los volúmenes de ambos ventrículos. En el seguimiento se evaluó un punto final combinado: hospitalización por arritmia ventricular, descarga apropiada de cardiodesfibrilador implantable y muerte cardíaca. Resultados: durante una mediana de seguimiento de 575 días (rango intercuartil 24-1120 días) y al analizar la población según tuvieran (n=9, 12%) o no (n=65, 88%) RTG se observó que el grupo con Gd positivo presentaba una FEVI menor (58% vs. 66% respectivamente, p=0.01) y volúmenes mayores (VTD: 185 ml vs. 123 ml respectivamente, p=0.01 y VTS: 81 ml vs. 42 ml respectivamente, p=0.01) que el otro grupo. Dos (22%) pacientes del grupo RTG positivo vs. 1 (4%) de aquellos sin RTG presentaron el punto final combinado (p=0.01) y al realizar un análisis de regresión logística se halló que el RTG es predictor de los eventos cardíacos adversos analizados (p=0.029). Conclusiones: en esta serie consecutiva de pacientes con arritmia ventricular demostramos una fuerte asociación entre el RTG miocárdico y eventos cardíacos adversos; esto soporta la hipótesis que la fibrosis miocárdica es un importante sustrato arritmogénico. Además, casi la totalidad de los individuos sin RTG estuvieron libres de eventos en el seguimiento sugiriendo que es posible identificar a través de la RMC sujetos de bajo riesgo los cuales pueden ser tratados conservadoramente. (autores)}
journal = {Revista de la Federacion Argentina de Cardiologia}
issue = {3}
volume = {41}
journal type = {AC}
place = {Argentina}
year = {2012}
month = {Jul}
}