Left Ventricular Late Gadolinium Enhancement for Arrhythmic Risk Prediction in ARVC.
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De Marco Corrado, Asatryan Babken, Te Riele Anneline S J M, Di Marco Andrea, Gasperetti Alessio, Delinière Antoine, Roberts Jason D, Jensen Henrik K, Davies Brianna, Krahn Andrew D, Tadros Rafik, Svensson Anneli, Castelletti Silvia, Crotti Lia, Platonov Pyotr G, Borowiec Karolina, Biernacka Elżbieta K, Arbelo Elena, David Louis-Philippe, Saguner Ardan M, Healey Jeff S, Brunckhorst Corinna, Cappelletto Chiara, Stolfo Davide, Merlo Marco, Rootwelt-Norberg Christine, Haugaa Kristina H, Duru Firat, van Tintelen J Peter, Velthuis Birgitta K, Calkins Hugh, Zimmerman Stefan L, James Cynthia A, Bosman Laurens P, Cadrin-Tourigny Julia
Аннотация
METHODS: Patients with definite ARVC, no prior sustained VA, and contrast-enhanced cardiac magnetic resonance at baseline were followed at 17 centers. Survival analyses were performed to assess LV LGE effect on VA prediction, and its incremental prognostic value on the risk calculator was evaluated using Cox proportional hazard models. The presence of high-risk LGE, defined as LV epicardial, transmural, or combined septal and free-wall LGE, was studied as a sensitivity analysis.
RESULTS: Of 385 patients (39.6±15.4 years, 39.7% male, 54.0% probands), 132 (34.3%) had LV LGE on cardiac magnetic resonance, with 98 (25.5%) having a high-risk pattern. Over 3.1 [1.2-5.8] years of follow-up, 67 (17.4%) patients experienced VA. In univariable analysis, both LV LGE (hazard ratio, 1.82; P=0.014) and high-risk LV LGE (hazard ratio, 1.85; P=0.017) were associated with higher risk for VA. However, after adjusting for the ARVC calculator-estimated risk, the presence of neither LV LGE (P=0.85) nor high-risk LV LGE (P=0.87) independently predicted sustained VA. (graphic abstract).
CONCLUSIONS: While associated with the risk of VA in ARVC, LV LGE did not provide incremental prognostic value for incident VA risk prediction compared with the ARVC risk calculator.