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Cardiac Magnetic Resonance Scar Imaging for Sudden Cardiac Death Risk Stratification in Patients with Non-Ischemic Cardiomyopathy

  • Kim, Eun Kyoung (Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chattranukulchai, Pairoj (Division of Cardiology, Department of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital) ;
  • Klem, Igor (Duke Cardiovascular Magnetic Resonance Center, Duke University Medical Center)
  • Received : 2015.03.20
  • Accepted : 2015.05.13
  • Published : 2015.08.01

Abstract

In patients with non-ischemic cardiomyopathy (NICM), risk stratification for sudden cardiac death (SCD) and selection of patients who would benefit from prophylactic implantable cardioverter-defibrillators remains challenging. We aim to discuss the evidence of cardiac magnetic resonance (CMR)-derived myocardial scar for the prediction of adverse cardiovascular outcomes in NICM. From the 15 studies analyzed, with a total of 2747 patients, the average prevalence of myocardial scar was 41%. In patients with myocardial scar, the risk for adverse cardiac events was more than 3-fold higher, and risk for arrhythmic events 5-fold higher, as compared to patients without scar. Based on the available observational, single center studies, CMR scar assessment may be a promising new tool for SCD risk stratification, which merits further investigation.

Keywords

References

  1. Jefferies JL, Towbin JA. Dilated cardiomyopathy. Lancet 2010;375:752-762 https://doi.org/10.1016/S0140-6736(09)62023-7
  2. Felker GM, Thompson RE, Hare JM, Hruban RH, Clemetson DE, Howard DL, et al. Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy. N Engl J Med 2000;342:1077-1084 https://doi.org/10.1056/NEJM200004133421502
  3. Lee SE, Cho HJ, Lee HY, Yang HM, Choi JO, Jeon ES, et al. A multicentre cohort study of acute heart failure syndromes in Korea: rationale, design, and interim observations of the Korean Acute Heart Failure (KorAHF) registry. Eur J Heart Fail 2014;16:700-708 https://doi.org/10.1002/ejhf.91
  4. Choi DJ, Han S, Jeon ES, Cho MC, Kim JJ, Yoo BS, et al. Characteristics, outcomes and predictors of long-term mortality for patients hospitalized for acute heart failure: a report from the Korean heart failure registry. Korean Circ J 2011;41:363-371 https://doi.org/10.4070/kcj.2011.41.7.363
  5. Tamburro P, Wilber D. Sudden death in idiopathic dilated cardiomyopathy. Am Heart J 1992;124:1035-1045 https://doi.org/10.1016/0002-8703(92)90989-9
  6. Kim J, Choi EK, Lee MH, Kang DY, Sung YJ, Lee DW, et al. The relevance of the primary prevention criteria for implantable cardioverter defibrillator implantation in Korean symptomatic severe heart failure patients. Korean Circ J 2012;42:173-183 https://doi.org/10.4070/kcj.2012.42.3.173
  7. Desai AS, Fang JC, Maisel WH, Baughman KL. Implantable defibrillators for the prevention of mortality in patients with nonischemic cardiomyopathy: a meta-analysis of randomized controlled trials. JAMA 2004;292:2874-2879 https://doi.org/10.1001/jama.292.23.2874
  8. Bansch D, Antz M, Boczor S, Volkmer M, Tebbenjohanns J, Seidl K, et al. Primary prevention of sudden cardiac death in idiopathic dilated cardiomyopathy: the Cardiomyopathy Trial (CAT). Circulation 2002;105:1453-1458 https://doi.org/10.1161/01.CIR.0000012350.99718.AD
  9. Strickberger SA, Hummel JD, Bartlett TG, Frumin HI, Schuger CD, Beau SL, et al. Amiodarone versus implantable cardioverter-defibrillator: randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia--AMIOVIRT. J Am Coll Cardiol 2003;41:1707-1712 https://doi.org/10.1016/S0735-1097(03)00297-3
  10. Kadish A, Dyer A, Daubert JP, Quigg R, Estes NA, Anderson KP, et al. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med 2004;350:2151-2158 https://doi.org/10.1056/NEJMoa033088
  11. Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 2005;352:225-237 https://doi.org/10.1056/NEJMoa043399
  12. Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T, et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 2004;350:2140-2150 https://doi.org/10.1056/NEJMoa032423
  13. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA 3rd, Freedman RA, Gettes LS, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices) developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. J Am Coll Cardiol 2008;51:e1-e62 https://doi.org/10.1016/j.jacc.2008.02.032
  14. Kim JS. Guidelines for using the implantable cardioverter-defibrillator (ICD). Arrhythmia 2012;13:4-6
  15. Ezekowitz JA, Rowe BH, Dryden DM, Hooton N, Vandermeer B, Spooner C, et al. Systematic review: implantable cardioverter defibrillators for adults with left ventricular systolic dysfunction. Ann Intern Med 2007;147:251-262 https://doi.org/10.7326/0003-4819-147-4-200708210-00007
  16. Levy WC, Lee KL, Hellkamp AS, Poole JE, Mozaffarian D, Linker DT, et al. Maximizing survival benefit with primary prevention implantable cardioverter-defibrillator therapy in a heart failure population. Circulation 2009;120:835-842 https://doi.org/10.1161/CIRCULATIONAHA.108.816884
  17. Goldberger JJ, Subacius H, Patel T, Cunnane R, Kadish AH. Sudden cardiac death risk stratification in patients with nonischemic dilated cardiomyopathy. J Am Coll Cardiol 2014;63:1879-1889 https://doi.org/10.1016/j.jacc.2013.12.021
  18. Kim RJ, Fieno DS, Parrish TB, Harris K, Chen EL, Simonetti O, et al. Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. Circulation 1999;100:1992-2002 https://doi.org/10.1161/01.CIR.100.19.1992
  19. Assomull RG, Prasad SK, Lyne J, Smith G, Burman ED, Khan M, et al. Cardiovascular magnetic resonance, fibrosis, and prognosis in dilated cardiomyopathy. J Am Coll Cardiol 2006;48:1977-1985 https://doi.org/10.1016/j.jacc.2006.07.049
  20. Richards DA, Blake GJ, Spear JF, Moore EN. Electrophysiologic substrate for ventricular tachycardia: correlation of properties in vivo and in vitro. Circulation 1984;69:369-381 https://doi.org/10.1161/01.CIR.69.2.369
  21. Hsia HH, Callans DJ, Marchlinski FE. Characterization of endocardial electrophysiological substrate in patients with nonischemic cardiomyopathy and monomorphic ventricular tachycardia. Circulation 2003;108:704-710 https://doi.org/10.1161/01.CIR.0000083725.72693.EA
  22. Soejima K, Stevenson WG, Sapp JL, Selwyn AP, Couper G, Epstein LM. Endocardial and epicardial radiofrequency ablation of ventricular tachycardia associated with dilated cardiomyopathy: the importance of low-voltage scars. J Am Coll Cardiol 2004;43:1834-1842 https://doi.org/10.1016/j.jacc.2004.01.029
  23. Gulati A, Jabbour A, Ismail TF, Guha K, Khwaja J, Raza S, et al. Association of fibrosis with mortality and sudden cardiac death in patients with nonischemic dilated cardiomyopathy. JAMA 2013;309:896-908 https://doi.org/10.1001/jama.2013.1363
  24. Senthilkumar A, Majmudar MD, Shenoy C, Kim HW, Kim RJ. Identifying the etiology: a systematic approach using delayed-enhancement cardiovascular magnetic resonance. Heart Fail Clin 2009;5:349-367, vi https://doi.org/10.1016/j.hfc.2009.02.009
  25. Writing Committee Members, Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 2013;128:e240-e327 https://doi.org/10.1161/CIR.0b013e31829e8776
  26. Patel MR, Cawley PJ, Heitner JF, Klem I, Parker MA, Jaroudi WA, et al. Detection of myocardial damage in patients with sarcoidosis. Circulation 2009;120:1969-1977 https://doi.org/10.1161/CIRCULATIONAHA.109.851352
  27. Wu E, Judd RM, Vargas JD, Klocke FJ, Bonow RO, Kim RJ. Visualisation of presence, location, and transmural extent of healed Q-wave and non-Q-wave myocardial infarction. Lancet 2001;357:21-28 https://doi.org/10.1016/S0140-6736(00)03567-4
  28. Hombach V, Merkle N, Torzewski J, Kraus JM, Kunze M, Zimmermann O, et al. Electrocardiographic and cardiac magnetic resonance imaging parameters as predictors of a worse outcome in patients with idiopathic dilated cardiomyopathy. Eur Heart J 2009;30:2011-2018 https://doi.org/10.1093/eurheartj/ehp293
  29. Lehrke S, Lossnitzer D, Schob M, Steen H, Merten C, Kemmling H, et al. Use of cardiovascular magnetic resonance for risk stratification in chronic heart failure: prognostic value of late gadolinium enhancement in patients with non-ischaemic dilated cardiomyopathy. Heart 2011;97:727-732 https://doi.org/10.1136/hrt.2010.205542
  30. Neilan TG, Coelho-Filho OR, Danik SB, Shah RV, Dodson JA, Verdini DJ, et al. CMR quantification of myocardial scar provides additive prognostic information in nonischemic cardiomyopathy. JACC Cardiovasc Imaging 2013;6:944-954 https://doi.org/10.1016/j.jcmg.2013.05.013
  31. Perazzolo Marra M, De Lazzari M, Zorzi A, Migliore F, Zilio F, Calore C, et al. Impact of the presence and amount of myocardial fibrosis by cardiac magnetic resonance on arrhythmic outcome and sudden cardiac death in nonischemic dilated cardiomyopathy. Heart Rhythm 2014;11:856-863 https://doi.org/10.1016/j.hrthm.2014.01.014
  32. Cho JR, Park S, Choi BW, Kang SM, Ha JW, Chung N, et al. Delayed enhancement magnetic resonance imaging is a significant prognostic factor in patients with non-ischemic cardiomyopathy. Circ J 2010;74:476-483 https://doi.org/10.1253/circj.CJ-09-0446
  33. Richardson P, McKenna W, Bristow M, Maisch B, Mautner B, O'Connell J, et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation 1996;93:841-842 https://doi.org/10.1161/01.CIR.93.5.841
  34. Gao P, Yee R, Gula L, Krahn AD, Skanes A, Leong-Sit P, et al. Prediction of arrhythmic events in ischemic and dilated cardiomyopathy patients referred for implantable cardiac defibrillator: evaluation of multiple scar quantification measures for late gadolinium enhancement magnetic resonance imaging. Circ Cardiovasc Imaging 2012;5:448-456 https://doi.org/10.1161/CIRCIMAGING.111.971549
  35. Masci PG, Doulaptsis C, Bertella E, Del Torto A, Symons R, Pontone G, et al. Incremental prognostic value of myocardial fibrosis in patients with non-ischemic cardiomyopathy without congestive heart failure. Circ Heart Fail 2014;7:448-456 https://doi.org/10.1161/CIRCHEARTFAILURE.113.000996
  36. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. 2009 focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 2009;119:e391-e479 https://doi.org/10.1161/CIRCULATIONAHA.109.192065
  37. Uretsky BF, Thygesen K, Armstrong PW, Cleland JG, Horowitz JD, Massie BM, et al. Acute coronary findings at autopsy in heart failure patients with sudden death: results from the assessment of treatment with lisinopril and survival (ATLAS) trial. Circulation 2000;102:611-616 https://doi.org/10.1161/01.CIR.102.6.611
  38. Roberts WC, Siegel RJ, McManus BM. Idiopathic dilated cardiomyopathy: analysis of 152 necropsy patients. Am J Cardiol 1987;60:1340-1355 https://doi.org/10.1016/0002-9149(87)90618-7
  39. Topol EJ, Yadav JS. Recognition of the importance of embolization in atherosclerotic vascular disease. Circulation 2000;101:570-580 https://doi.org/10.1161/01.CIR.101.5.570
  40. Kim HW, Klem I, Shah DJ, Wu E, Meyers SN, Parker MA, et al. Unrecognized non-Q-wave myocardial infarction: prevalence and prognostic significance in patients with suspected coronary disease. PLoS Med 2009;6:e1000057 https://doi.org/10.1371/journal.pmed.1000057
  41. Muller KA, Muller I, Kramer U, Kandolf R, Gawaz M, Bauer A, et al. Prognostic value of contrast-enhanced cardiac magnetic resonance imaging in patients with newly diagnosed non-ischemic cardiomyopathy: cohort study. PLoS One 2013;8:e57077 https://doi.org/10.1371/journal.pone.0057077
  42. Cheong BY, Muthupillai R, Wilson JM, Sung A, Huber S, Amin S, et al. Prognostic significance of delayed-enhancement magnetic resonance imaging: survival of 857 patients with and without left ventricular dysfunction. Circulation 2009;120:2069-2076 https://doi.org/10.1161/CIRCULATIONAHA.109.852517
  43. Klem I, Weinsaft JW, Bahnson TD, Hegland D, Kim HW, Hayes B, et al. Assessment of myocardial scarring improves risk stratification in patients evaluated for cardiac defibrillator implantation. J Am Coll Cardiol 2012;60:408-420 https://doi.org/10.1016/j.jacc.2012.02.070
  44. Wu KC, Weiss RG, Thiemann DR, Kitagawa K, Schmidt A, Dalal D, et al. Late gadolinium enhancement by cardiovascular magnetic resonance heralds an adverse prognosis in nonischemic cardiomyopathy. J Am Coll Cardiol 2008;51:2414-2421 https://doi.org/10.1016/j.jacc.2008.03.018
  45. Wu KC, Gerstenblith G, Guallar E, Marine JE, Dalal D, Cheng A, et al. Combined cardiac magnetic resonance imaging and C-reactive protein levels identify a cohort at low risk for defibrillator firings and death. Circ Cardiovasc Imaging 2012;5:178-186 https://doi.org/10.1161/CIRCIMAGING.111.968024
  46. Iles L, Pfluger H, Lefkovits L, Butler MJ, Kistler PM, Kaye DM, et al. Myocardial fibrosis predicts appropriate device therapy in patients with implantable cardioverter-defibrillators for primary prevention of sudden cardiac death. J Am Coll Cardiol 2011;57:821-828 https://doi.org/10.1016/j.jacc.2010.06.062
  47. Ahmed A, Rich MW, Love TE, Lloyd-Jones DM, Aban IB, Colucci WS, et al. Digoxin and reduction in mortality and hospitalization in heart failure: a comprehensive post hoc analysis of the DIG trial. Eur Heart J 2006;27:178-186 https://doi.org/10.1093/eurheartj/ehi687
  48. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. Lancet 1999;354:447-455 https://doi.org/10.1016/S0140-6736(99)07072-5
  49. Huikuri HV, Castellanos A, Myerburg RJ. Sudden death due to cardiac arrhythmias. N Engl J Med 2001;345:1473-1482 https://doi.org/10.1056/NEJMra000650
  50. Stecker EC, Vickers C, Waltz J, Socoteanu C, John BT, Mariani R, et al. Population-based analysis of sudden cardiac death with and without left ventricular systolic dysfunction: two-year findings from the Oregon Sudden Unexpected Death Study. J Am Coll Cardiol 2006;47:1161-1166 https://doi.org/10.1016/j.jacc.2005.11.045
  51. Gorgels AP, Gijsbers C, de Vreede-Swagemakers J, Lousberg A, Wellens HJ. Out-of-hospital cardiac arrest--the relevance of heart failure. The Maastricht Circulatory Arrest Registry. Eur Heart J 2003;24:1204-1209 https://doi.org/10.1016/S0195-668X(03)00191-X
  52. McCrohon JA, Moon JC, Prasad SK, McKenna WJ, Lorenz CH, Coats AJ, et al. Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance. Circulation 2003;108:54-59 https://doi.org/10.1161/01.CIR.0000078641.19365.4C
  53. Yoon YE, Hong YJ, Kim HK, Kim JA, Na JO, Yang DH, et al. 2014 Korean guidelines for appropriate utilization of cardiovascular magnetic resonance imaging: a joint report of the Korean Society of Cardiology and the Korean Society of Radiology. Korean Circ J 2014;44:359-385 https://doi.org/10.4070/kcj.2014.44.6.359

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