Cardiac magnetic resonance imaging with late gadolinium enhancement provides prognostic value in phenotyping the left ventricle to identify individuals at highest risk for sudden cardiac death.
Does cardiac magnetic resonance imaging with late gadolinium enhancement improve risk stratification for sudden cardiac death compared to LVEF alone?
CMR with LGE offers detailed myocardial tissue characterization that may improve sudden cardiac death risk stratification beyond the traditional LVEF <35% threshold.
Sudden cardiac death (SCD) is a devastating event afflicting 350 000 Americans annually despite the availability of life-saving preventive therapy, the implantable cardioverter defibrillator. SCD prevention strategies are hampered by over-reliance on global left ventricular ejection fraction 3 billion but only a 5% incidence per year of appropriate firings. This approach further fails to identify individuals who experience the majority, as many as 80%, of SCD events, which occur in the setting of more preserved left ventricular ejection fraction. Better risk stratification is needed to improve care and should be guided by direct pathophysiologic markers of arrhythmic substrate, such as specific left ventricular structural abnormalities. There is an increasing body of literature to support the prognostic value of cardiac magnetic resonance imaging with late gadolinium enhancement in phenotyping the left ventricular to identify those at highest risk for SCD. Cardiac magnetic resonance has unparalleled tissue characterization ability and provides exquisite detail about myocardial structure and composition, abnormalities of which form the direct, pathophysiologic substrate for SCD. Here, we review the evolution and the current state of cardiac magnetic resonance for imaging the arrhythmic substrate, both as a research tool and for clinical applications.
Kathérine C. Wu (Thu,) conducted a review in Sudden cardiac death. Cardiac magnetic resonance imaging with late gadolinium enhancement was evaluated. Cardiac magnetic resonance imaging with late gadolinium enhancement provides prognostic value in phenotyping the left ventricle to identify individuals at highest risk for sudden cardiac death.