Greyzone myocardial fibrosis and ventricular arrhythmias in patients with a left ventricular ejection fraction >35.
Date
2022-01-04ICR Author
Author
Zegard, A
Okafor, O
de Bono, J
Kalla, M
Lencioni, M
Marshall, H
Hudsmith, L
Qiu, T
Steeds, R
Stegemann, B
Leyva, F
Type
Journal Article
Metadata
Show full item recordAbstract
AIMS: To determine whether myocardial fibrosis and greyzone fibrosis (GZF) on cardiovascular magnetic resonance (CMR) is associated with ventricular arrhythmias in patients with coronary artery disease (CAD) and a left ventricular ejection fraction (LVEF) >35%. METHODS AND RESULTS: In this retrospective study of CAD patients, GZF mass using the 3SD method (GZF3SD) and total fibrosis mass using the 2SD method (TF2SD) on CMR were assessed in relation to the primary, combined endpoint of sudden cardiac death, ventricular tachycardia, ventricular fibrillation, or resuscitated cardiac arrest. Among 701 patients [age: 65.8 ± 12.3 years (mean ± SD)], 28 (3.99%) patients met the primary endpoint over 5.91 years (median; interquartile range 4.42-7.64). In competing risks analysis, a GZF3SD mass ≥5.0 g was strongly associated with the primary endpoint [subdistribution hazard ratio (sHR): 17.4 (95% confidence interval, CI 6.64-45.5); area under receiver operator characteristic curve (AUC): 0.85, P < 0.001]. A weaker association was observed for TF2SD mass ≥23 g [sHR 10.4 (95% CI 4.22-25.8); AUC: 0.80, P < 0.001]. The range of sHRs for GZF3SD mass (1-527) was wider than for TF2SD mass (1-37.6). CONCLUSIONS: In CAD patients with an LVEF >35%, GZF3SD mass was strongly associated with the arrhythmic endpoint. These findings hold promise for its use in identifying patients with CAD and an LVEF >35% at risk of arrhythmic events.
Collections
Subject
Cardiovascular magnetic resonance
Coronary artery disease
Greyzone scar
Myocardial fibrosis
Sudden cardiac death
Ventricular fibrillation
Ventricular tachycardia
Aged
Arrhythmias, Cardiac
Death, Sudden, Cardiac
Fibrosis
Humans
Magnetic Resonance Imaging, Cine
Middle Aged
Myocardium
Retrospective Studies
Stroke Volume
Ventricular Function, Left
Research team
PrCa Targeted Therapy
Language
eng
Date accepted
2021-01-04
License start date
2022-01-04
Citation
Europace, 2022, 24 (1), pp. 31 - 39
Publisher
OXFORD UNIV PRESS