Key result
Left ventricular longitudinal dyssynchrony ≥ 89.15 ms assessed by CMR feature tracking was an independent risk factor for cardiovascular events (HR 4.50) in patients with advanced arrhythmogenic cardiomyopathy.
Why the study?
LV involvement is associated with unfavorable prognosis in arrhythmogenic cardiomyopathy, but LV mechanics evaluated by CMR-FT in patients with RV dysfunction required evaluation.
Does left ventricular longitudinal dyssynchrony assessed by CMR-FT predict cardiovascular and arrhythmic events in patients with advanced arrhythmogenic cardiomyopathy?
Cohort (n=89)
No
Does left ventricular longitudinal dyssynchrony assessed by CMR-FT predict cardiovascular and arrhythmic events in patients with advanced arrhythmogenic cardiomyopathy?
Left ventricular longitudinal dyssynchrony assessed by CMR-FT provides independent prognostic value for cardiovascular and arrhythmic events in patients with advanced arrhythmogenic cardiomyopathy.
LV longitudinal dyssynchrony may refine prognostication in advanced ACM; hypothesis-generating and requires prospective validation before clinical adoption.
Objectives: Left ventricular (LV) involvement has been associated with unfavorable prognosis in arrhythmogenic cardiomyopathy (ACM). We aim to evaluate LV mechanics by cardiovascular magnetic resonance-feature tracking (CMR-FT) in ACM patients with right ventricular (RV) dysfunction. Methods: We retrospectively recruited ACM patients diagnosed according to the revised Task Force Criteria (rTFC) from January 2015 to July 2017. All patients underwent CMR examinations and collections of clinical, electrocardiographic data. The strain and dyssynchrony parameters of LV and RV were analyzed. These patients were followed, and primary study outcome was defined as a composite of cardiovascular events (arrhythmic events and heart transplantation), secondary study outcome included arrhythmic events. Results: Eighty-nine ACM patients (40.40 ± 13.98 years, 67.42% male) were included. LV and RV ejection fractions were 49.12 ± 12.02% and 22.28 ± 10.11%, respectively. During a median (IQR) follow-up for 18.20 (11.60-30.04) months, 30 patients experienced cardiovascular events which included 22 patients who experienced arrhythmic events. Patients with cardiovascular events had impaired LV global longitudinal strain (−10.82 ± 2.77 vs. −12.61 ± 3.18%, p = 0.010), impaired LV global circumferential strain (−11.81 ± 2.40 vs. −13.04 ± 2.83%, p = 0.044), and greater LV longitudinal dyssynchrony (LVLD) (80.98 ± 30.98 vs. 64.23 ± 25.51 ms, p = 0.012) than those without. After adjusting for age, sex, and other confounding factors, LVLD ≥89.15 ms was an independent risk factor for cardiovascular events (HR: 4.50, 95% CI: 1.94 to 10.42; p = 0.001) and for arrhythmic events (HR: 4.79, 95% CI: 1.74 to 13.20; p = 0.003). Conclusions: LVLD by CMR-FT was an independent risk factor for cardiovascular and arrhythmic events in ACM patients in advanced stage, which could provide prognostic value for this subtype.
No takes yet. Share an insight, caveat, or question.
Song et al. (2021) conducted a cohort in Advanced Arrhythmogenic Cardiomyopathy (n=89). Left ventricular longitudinal dyssynchrony (LVLD) ≥ 89.15 ms vs. LVLD < 89.15 ms was evaluated on Composite of cardiovascular events (arrhythmic events and heart transplantation) (HR 4.50, 95% CI 1.94-10.42, p=0.001). Left ventricular longitudinal dyssynchrony ≥ 89.15 ms assessed by CMR feature tracking was an independent risk factor for cardiovascular events (HR 4.50) in patients with advanced arrhythmogenic cardiomyopathy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: