Greyzone myocardial fibrosis and ventricular arrhythmias in patients with a left ventricular ejection fraction >35.
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ICR Authors
Authors
Zegard, A
Okafor, O
de Bono, J
Kalla, M
Lencioni, M
Marshall, H
Hudsmith, L
Qiu, T
Steeds, R
Stegemann, B
Leyva, F
Okafor, O
de Bono, J
Kalla, M
Lencioni, M
Marshall, H
Hudsmith, L
Qiu, T
Steeds, R
Stegemann, B
Leyva, F
Document Type
Journal Article
Date
2022-01-04
Date Accepted
2021-01-04
Abstract
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.
Citation
Europace, 2022, 24 (1), pp. 31 - 39
Source Title
Europace
Publisher
OXFORD UNIV PRESS
ISSN
1099-5129
eISSN
1532-2092
1532-2092
1532-2092
Collections
Research Team
PrCa Targeted Therapy