Diffuse myocardial fibrosis associates with incident ventricular arrhythmia in implantable cardioverter defibrillator recipients.
Eric OlaussonJonathon WertzYaron FridmanPatrick BeringMaren MaanjaLouise NiklassonTimothy C WongMiho FukuiJo O L CavalcanteGeorge CaterPeter KellmanSyed BukhariChristopher A MillerSamir SabaMartin UganderErik B SchelbertPublished in: medRxiv : the preprint server for health sciences (2023)
Analogous to heart failure and mortality outcomes, diffuse myocardial fibrosis (DMF) quantified by extracellular volume (ECV) may represent a more vulnerable phenotype for life-threatening ventricular arrhythmia than focal myocardial fibrosis. In patients referred for cardiovascular magnetic resonance, we identified 215 subsequently receiving implantable cardioverter defibrillators (ICD). After a median of 2.9 (IQR 1.5-4.2) years, 25 patients experienced ICD shock and 44 experienced shock or anti-tachycardia pacing. ECV associated with ICD therapy in Cox regression models. Focal fibrosis variables or global longitudinal strain did not. ECV-based risk stratification and DMF representing a therapeutic target to prevent ventricular arrhythmia warrant further investigation.
Keyphrases
- metabolic syndrome
- heart failure
- left ventricular
- catheter ablation
- end stage renal disease
- magnetic resonance
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- cardiac resynchronization therapy
- atrial fibrillation
- prognostic factors
- computed tomography
- stem cells
- type diabetes
- liver fibrosis
- skeletal muscle
- magnetic resonance imaging
- patient reported
- adipose tissue
- weight loss
- high grade
- contrast enhanced