CMR-Based Risk Stratification of Sudden Cardiac Death and Use of Implantable Cardioverter-Defibrillator in Non-Ischemic Cardiomyopathy.
Laura KeilCéleste ChevalierPaulus F KirchhofStefan BlankenbergGunnar LundKai MüllerleileChristina MagnussenPublished in: International journal of molecular sciences (2021)
Non-ischemic cardiomyopathy (NICM) is one of the most important entities for arrhythmias and sudden cardiac death (SCD). Previous studies suggest a lower benefit of implantable cardioverter-defibrillator (ICD) therapy in patients with NICM as compared to ischemic cardiomyopathy (ICM). Nevertheless, current guidelines do not differentiate between the two subgroups in recommending ICD implantation. Hence, risk stratification is required to determine the subgroup of patients with NICM who will likely benefit from ICD therapy. Various predictors have been proposed, among others genetic mutations, left-ventricular ejection fraction (LVEF), left-ventricular end-diastolic volume (LVEDD), and T-wave alternans (TWA). In addition to these parameters, cardiovascular magnetic resonance imaging (CMR) has the potential to further improve risk stratification. CMR allows the comprehensive analysis of cardiac function and myocardial tissue composition. A range of CMR parameters have been associated with SCD. Applicable examples include late gadolinium enhancement (LGE), T1 relaxation times, and myocardial strain. This review evaluates the epidemiological aspects of SCD in NICM, the role of CMR for risk stratification, and resulting indications for ICD implantation.
Keyphrases
- left ventricular
- aortic stenosis
- ejection fraction
- heart failure
- magnetic resonance imaging
- hypertrophic cardiomyopathy
- cardiac resynchronization therapy
- acute myocardial infarction
- left atrial
- mitral valve
- ischemia reperfusion injury
- blood pressure
- magnetic resonance
- genome wide
- randomized controlled trial
- cell therapy
- clinical trial
- transcatheter aortic valve replacement
- dna methylation
- atrial fibrillation
- aortic valve
- climate change
- single molecule
- coronary artery disease
- study protocol
- congenital heart disease
- mesenchymal stem cells
- bone marrow
- diffusion weighted imaging
- percutaneous coronary intervention
- human health