Cardiac Magnetic Resonance and Ventricular Arrhythmia Risk Assessment in Chronic Ischemic Cardiomyopathy: An Unmet Need?
Beatriz JaureguiNaiara CalvoTeresa OlórizCarlos López-PeralesAntonio AssoPublished in: Reviews in cardiovascular medicine (2022)
Ischemic cardiomyopathy (ICM) constitutes a major public health issue, directly involved in the prevalence and incidence of heart failure, ventricular arrhythmias (VA) and sudden cardiac death (SCD). Severe impairment of left ventricular ejection fraction (LVEF) is considered a high-risk marker for SCD, conditioning the criteria that determine an implantable cardiac defibrillator (ICD) placement in primary prevention according to current clinical guidelines. However, its sensitivity and specificity values for the prediction of SCD in ICM may not be highest. Myocardial characterization using cardiac magnetic resonance with late gadolinium enhancement (CMR-LGE) sequences has made it possible to answer clinically relevant questions that are currently not assessable with LVEF alone. There is growing scientific evidence in favor of the relationship between fibrosis evaluated with CMR and the appearance of VA/SCD in patients with ICM. This evidence should make us contemplate a more realistic clinical value of LVEF in our daily clinical decision-making.
Keyphrases
- left ventricular
- heart failure
- magnetic resonance
- cardiac resynchronization therapy
- aortic stenosis
- public health
- ejection fraction
- risk assessment
- hypertrophic cardiomyopathy
- acute myocardial infarction
- mitral valve
- left atrial
- risk factors
- decision making
- physical activity
- ischemia reperfusion injury
- contrast enhanced
- catheter ablation
- early onset
- ultrasound guided
- blood brain barrier
- human health
- cerebral ischemia
- atrial fibrillation
- subarachnoid hemorrhage
- percutaneous coronary intervention
- clinical practice
- acute coronary syndrome
- brain injury