Cardiovascular magnetic resonance imaging identified relevant myocardial disease in 74% of patients with resuscitated SCD or SMVT compared to 51% with non-CMR imaging (P=0.002).
Observational (n=82)
Blinded interpretation
Does CMR-based imaging improve diagnostic yield compared to non-CMR-based imaging in patients with resuscitated SCD or SMVT?
CMR provides a significantly higher diagnostic yield than non-CMR imaging in patients with resuscitated SCD or SMVT, leading to diagnosis reclassification in half of the patients.
Absolute Event Rate: 74% vs 51%
p-value: p=0.002
BACKGROUND: Sudden cardiac death (SCD) and sustained monomorphic ventricular tachycardia (SMVT) are frequently associated with prior or acute myocardial injury. Cardiovascular magnetic resonance (CMR) provides morphological, functional, and tissue characterization in a single setting. We sought to evaluate the diagnostic yield of CMR-based imaging versus non-CMR-based imaging in patients with resuscitated SCD or SMVT. METHODS AND RESULTS: Eighty-two patients with resuscitated SCD or SMVT underwent routine non-CMR imaging, followed by a CMR protocol with comprehensive tissue characterization. Clinical reports of non-CMR imaging studies were blindly adjudicated and used to assign each patient to 1 of 7 diagnostic categories. CMR imaging was blindly interpreted using a standardized algorithm used to assign a patient diagnosis category in a similar fashion. The diagnostic yield of CMR-based and non-CMR-based imaging, as well as the impact of the former on diagnosis reclassification, was established. Relevant myocardial disease was identified in 51% of patients using non-CMR-based imaging and in 74% using CMR-based imaging (P=0.002). Forty-one patients (50%) were reassigned to a new or alternate diagnosis using CMR-based imaging, including 15 (18%) with unsuspected acute myocardial injury. Twenty patients (24%) had no abnormality by non-CMR imaging but showed clinically relevant myocardial disease by CMR imaging. CONCLUSIONS: CMR-based imaging provides a robust diagnostic yield in patients presenting with resuscitated SCD or SMVT and incrementally identifies clinically unsuspected acute myocardial injury. When compared with non-CMR-based imaging, a new or alternate myocardial disease process may be identified in half of these patients.
White et al. (Sat,) conducted a observational in Resuscitated sudden cardiac death or sustained monomorphic ventricular tachycardia (n=82). Cardiovascular magnetic resonance (CMR) imaging vs. Routine non-CMR imaging was evaluated on Identification of relevant myocardial disease (p=0.002). Cardiovascular magnetic resonance imaging identified relevant myocardial disease in 74% of patients with resuscitated SCD or SMVT compared to 51% with non-CMR imaging (P=0.002).