Key result
Each 10% increase in moderately impaired strain links to ~50% greater appropriate ICD therapy risk.
Why the study?
Impaired LV contraction and relaxation may promote adverse remodeling and increase ventricular arrhythmia risk, but the prognostic value of CMR-derived circumferential strain parameters in post-MI primary prevention ICD patients was unclear.
Do CMR-derived circumferential strain parameters predict the risk of appropriate ICD therapy in patients with prior myocardial infarction and primary prevention ICD?
Population
121 ischemic cardiomyopathy patients with prior MI undergoing CMR before primary prevention ICD implantation
Comparison
CMR-derived circumferential strain parameters of LV systolic function, diastolic function, and mechanical dispersion
Design
Retrospective cohort study
Follow-up
Median 47 (27;69) months
Authors
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Moderately impaired strain was associated with higher ICD therapy risk; hypothesis-generating and needs prospective validation before guiding decisions.
Cohort (n=121)
No
Do CMR-derived circumferential strain parameters predict the risk of appropriate ICD therapy in patients with prior myocardial infarction and primary prevention ICD?
Effect estimate: HR 1.5 (95% CI 1.0-2.2)
p-value: p=0.048
In patients with ischemic cardiomyopathy and primary prevention ICDs, CMR-derived moderately impaired strain and late diastolic strain rate independently predict the risk of appropriate ICD therapy.
Paiman et al. (2019) conducted a cohort in Ischemic cardiomyopathy with prior myocardial infarction (n=121). Extent of moderately impaired strain (CMR-derived) was evaluated on Appropriate ICD therapy (HR 1.5, 95% CI 1.0-2.2, p=0.048). The extent of moderately impaired strain was associated with an increased risk of appropriate ICD therapy (HR 1.5 per +10%) in patients with ischemic cardiomyopathy and primary prevention ICD.
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