Myocardial scarring and recurrence of ventricular arrhythmia in patients surviving an out-of-hospital cardiac arrest
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Myocardial scarring and recurrence of ventricular arrhythmia in patients surviving an out-of-hospital cardiac arrest. / Thomsen, Anna F.; Winkel, Bo G.; Golvano, Leticia Camino Castrillo; Porta-Sánchez, Andreu; Jøns, Christian; Ferro, Elisenda; Bertelsen, Litten; Vazquez, Sara; Bhardwaj, Priya; Stampe, Niels Kjær; Ortiz-Perez, José T.; Andrea, Rut; Engstrøm, Thomas; Køber, Lars; Vejlstrup, Niels; Mont, Lluís; Roca-Luque, Ivo; Jacobsen, Peter K.
I: Journal of Cardiovascular Electrophysiology, Bind 34, Nr. 11, 2023, s. 2286-2295.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Myocardial scarring and recurrence of ventricular arrhythmia in patients surviving an out-of-hospital cardiac arrest
AU - Thomsen, Anna F.
AU - Winkel, Bo G.
AU - Golvano, Leticia Camino Castrillo
AU - Porta-Sánchez, Andreu
AU - Jøns, Christian
AU - Ferro, Elisenda
AU - Bertelsen, Litten
AU - Vazquez, Sara
AU - Bhardwaj, Priya
AU - Stampe, Niels Kjær
AU - Ortiz-Perez, José T.
AU - Andrea, Rut
AU - Engstrøm, Thomas
AU - Køber, Lars
AU - Vejlstrup, Niels
AU - Mont, Lluís
AU - Roca-Luque, Ivo
AU - Jacobsen, Peter K.
N1 - Publisher Copyright: © 2023 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals LLC.
PY - 2023
Y1 - 2023
N2 - Introduction: Prediction of recurrent ventricular arrhythmia (VA) in survivors of an out-of-hospital cardiac arrest (OHCA) is important, but currently difficult. Risk of recurrence may be related to presence of myocardial scarring assessed with late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Our study aims to characterize myocardial scarring as defined by LGE-CMR in survivors of a VA-OHCA and investigate its potential role in the risk of new VA events. Methods: Between 2015 and 2022, a total of 230 VA-OHCA patients without ST-segment elevation myocardial infarction had CMR before implantable cardioverter-defibrillator implantation for secondary prevention at Copenhagen University Hospital, Rigshospitalet, and Hospital Clínic, University of Barcelona, of which n = 170 patients had a conventional (no LGE protocol) CMR and n = 60 patients had LGE-CMR (including LGE protocol). Scar tissue including core, border zone (BZ) and BZ channels were automatically detected by specialized investigational software in patients with LGE-CMR. The primary endpoint was recurrent VA. Results: After exclusion, n = 52 VA-OHCA patients with LGE-CMR and a mean left ventricular ejection fraction of 49 ± 16% were included, of which 18 (32%) patients reached the primary endpoint of VA. Patients with recurrent VA in exhibited greater scar mass, core mass, BZ mass, and presence of BZ channels compared with patients without recurrent VA. The presence of BZ channels identified patients with recurrent VA with 67% sensitivity and 85% specificity (area under the ROC curve (AUC) 0.76; 95% CI: 0.63–0.89; p <.001) and was the strongest predictor of the primary endpoint. Conclusions: The presence of BZ channels was the strongest predictor of recurrent VA in patients with an out of-hospital cardiac arrest and LGE-CMR.
AB - Introduction: Prediction of recurrent ventricular arrhythmia (VA) in survivors of an out-of-hospital cardiac arrest (OHCA) is important, but currently difficult. Risk of recurrence may be related to presence of myocardial scarring assessed with late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Our study aims to characterize myocardial scarring as defined by LGE-CMR in survivors of a VA-OHCA and investigate its potential role in the risk of new VA events. Methods: Between 2015 and 2022, a total of 230 VA-OHCA patients without ST-segment elevation myocardial infarction had CMR before implantable cardioverter-defibrillator implantation for secondary prevention at Copenhagen University Hospital, Rigshospitalet, and Hospital Clínic, University of Barcelona, of which n = 170 patients had a conventional (no LGE protocol) CMR and n = 60 patients had LGE-CMR (including LGE protocol). Scar tissue including core, border zone (BZ) and BZ channels were automatically detected by specialized investigational software in patients with LGE-CMR. The primary endpoint was recurrent VA. Results: After exclusion, n = 52 VA-OHCA patients with LGE-CMR and a mean left ventricular ejection fraction of 49 ± 16% were included, of which 18 (32%) patients reached the primary endpoint of VA. Patients with recurrent VA in exhibited greater scar mass, core mass, BZ mass, and presence of BZ channels compared with patients without recurrent VA. The presence of BZ channels identified patients with recurrent VA with 67% sensitivity and 85% specificity (area under the ROC curve (AUC) 0.76; 95% CI: 0.63–0.89; p <.001) and was the strongest predictor of the primary endpoint. Conclusions: The presence of BZ channels was the strongest predictor of recurrent VA in patients with an out of-hospital cardiac arrest and LGE-CMR.
KW - cardiac magnetic resonance
KW - late gadolinium enhancement
KW - out-of-hospital cardiac arrest
KW - scarring
KW - ventricular arrhythmia
U2 - 10.1111/jce.16058
DO - 10.1111/jce.16058
M3 - Journal article
C2 - 37681321
AN - SCOPUS:85170038563
VL - 34
SP - 2286
EP - 2295
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
SN - 1045-3873
IS - 11
ER -
ID: 395910693