CarDiac magnEtic Resonance for Prophylactic Implantable-cardio Verter defibrillAtor ThErapy in Non-Ischaemic dilated CardioMyopathy: an international Registry

被引：53

作者：

Guaricci, Andrea Igoren ^{[1
]}

Masci, Pier Giorgio ^{[2
]}

Muscogiuri, Giuseppe ^{[3
]}

Guglielmo, Marco ^{[3
]}

Baggiano, Andrea ^{[3
]}

Fusini, Laura ^{[3
]}

Lorenzoni, Valentina ^{[4
]}

Martini, Chiara ^{[5
]}

Andreini, Daniele ^{[3
]}

Pavon, Anna Giulia ^{[6
]}

Aquaro, Giovanni D. ^{[7
]}

Barison, Andrea ^{[7
]}

Todiere, Giancarlo ^{[7
]}

Rabbat, Mark G. ^{[8
]}

Tat, Emily ^{[8
]}

Raineri, Claudia ^{[9
]}

Valentini, Adele ^{[10
]}

Varga-Szemes, Akos ^{[11
]}

Schoepf, U. Joseph ^{[11
]}

De Cecco, Carlo N. ^{[11
,12
]}

Bogaert, Jan ^{[13
]}

Dobrovie, Monica ^{[13
]}

Symons, Rolf ^{[13
]}

Focardi, Marta ^{[14
]}

Gismondi, Annalaura ^{[14
]}

Lozano-Torres, Jordi ^{[15
]}

Rodriguez-Palomares, Jose F. ^{[15
,16
]}

Lanzillo, Chiara ^{[17
]}

Di Roma, Mauro ^{[17
]}

Moro, Claudio ^{[18
]}

Di Giovine, Gabriella ^{[19
]}

Margonato, Davide ^{[19
]}

De Lazzari, Manuel ^{[20
]}

Marra, Martina Perazzolo ^{[20
]}

Nese, Alberto ^{[21
]}

Casavecchia, Grazia ^{[22
]}

Gravina, Matteo ^{[23
]}

Marzo, Francesca ^{[24
]}

Carigi, Samuela ^{[24
]}

Pica, Silvia ^{[25
]}

Lombardi, Massimo ^{[25
]}

Censi, Stefano ^{[26
]}

Squeri, Angelo ^{[26
]}

Palumbo, Alessandro ^{[5
]}

Gaibazzi, Nicola ^{[27
]}

Camastra, Giovanni ^{[28
]}

Sbarbati, Stefano ^{[29
]}

Pedrotti, Patrizia ^{[30
]}

Masi, Ambra ^{[30
]}

Carrabba, Nazario ^{[31
]}

机构：

[1] Policlin Univ Hosp, Univ Cardiol Unit, Bari, Italy

[2] Kings Coll London, Cardiovasc Imaging Dept, London, England

[3] IRCCS, Ctr Cardiol Monzino, Dept Cardiovasc, Via C Parea 4, I-20138 Milan, Italy

[4] Scuola Super Sant Anna, Inst Management, Pisa, Italy

[5] Univ Parma, Dept Med & Surg, Sci Radiol, Parma, Italy

[6] Univ Hosp Lausanne, CHUV, CMR Ctr, Cardiovasc Dept, Lausanne, Switzerland

[7] Fdn G Monasterio CNR Reg Toscana Pisa, UOC Risonanza Magnet Immagini, Pisa, Italy

[8] Loyola Univ, Chicago, IL 60611 USA

[9] Osped Molinette Turin, Citta Salute & Sci, Dept Cardiol, Pavia, Italy

[10] Fdn IRCCS Policlin S Matteo, Dept Radiol, Pavia, Italy

[11] Med Univ South Carolina, Dept Radiol & Radiol Sci, Div Cardiovasc Imaging, Charleston, SC 29425 USA

[12] Emory Univ, Div Cardiothorac Imaging, Atlanta, GA 30322 USA

[13] Univ Hosp Leuven, Dept Radiol, Leuven, Belgium

[14] Univ Siena, Dept Med Biotechnol, Div Cardiol, Siena, Italy

[15] Univ Autonoma Barcelona, Vall dHebron Inst Recerca VHIR, Dept Cardiol, Barcelona, Spain

[16] CIBER CV, Ctr Invest Biomed Red CV, Madrid, Spain

[17] Policlin Casilino, Cardiol Dept, Rome, Italy

[18] ASST Monza, Dept Cardiol, Po Desio, Italy

[19] Policlin Monza, Dept Cardiol, Monza, Italy

[20] Univ Foggia, Dept Radiol, Foggia, Italy

[21] Univ Padua, Med Sch, Dept Cardiac Thorac Vasc Sci & Publ Hlth, Padua, Italy

[22] Ca Foncello Hosp Azienda N 2 Marca Trevigiana, Cardiol Dept, Treviso, Italy

[23] Univ Foggia, Dept Med & Surg Sci, Foggia, Italy

[24] Infermi Hosp, Dept Cardiol, Rimini, Italy

[25] IRCCS Policlin San Donato, Multimodal Cardiac Imaging Sect, Milan, Italy

[26] Maria Cecilia Hosp, GVM Care & Res, Cotignola, RA, Italy

[27] Azienda Osped Univ, Dept Cardiol, Parma, Italy

[28] Vannini Hosp Rome, Cardiac Dept, Rome, Italy

[29] Vannini Hosp Rome, Radiol Dept, Rome, Italy

[30] ASST Grande Osped Metropolitano Niguarda, De Gasperis Cardio Ctr, Milan, Italy

[31] Careggi Hosp, Cardiovasc & Thorac Dept, Florence, Italy

[32] Careggi Hosp, Dept Radiol, Florence, Italy

[33] SS Annunziata Hosp, Dept Neurosci Imaging & Clin Sci, Chieti, Italy

[34] Lausanne Univ, Fac Biol & Med, Lausanne, Switzerland

来源：

EUROPACE | 2021年 / 23卷 / 07期

关键词：

Non-ischaemic dilated cardiomyopathy; Heart failure; Implantable cardioverter-defibrillator; Cardiac magnetic resonance; Primary prevention; MYOCARDIAL FIBROSIS; PRIMARY PREVENTION; GENDER-DIFFERENCES; SUDDEN-DEATH; HEART; RISK; QUANTIFICATION; MORTALITY;

D O I：

10.1093/europace/euaa401

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims The aim of this registry was to evaluate the additional prognostic value of a composite cardiac magnetic resonance (CMR)-based risk score over standard-of-care (SOC) evaluation in a large cohort of consecutive unselected nonischaemic cardiomyopathy (NICM) patients. Methods and Results In the DERIVATE registry (www.clinicaltrials.goviregistration: RCT#NCT03352648), 1000 (derivation cohort) and 508 (validation cohort) NICM patients with chronic heart failure (HF) and left ventricular ejection fraction <50% were included. All-cause mortality and major adverse arrhythmic cardiac events (MAACE) were the primary and secondary endpoints, respectively. During a median follow-up of 959 days, all-cause mortality and MAACE occurred in 72 (7%) and 93 (9%) patients, respectively. Age and >3 segments with midwall fibrosis on late gadolinium enhancement (LGE) were the only independent predictors of all-cause mortality (HR: 1.036, 95% CI: 1.0117 1.056, P< 0.001 and HR: 2.077, 95% CI: 1.211 3.562, P=0.008, respectively). For MAACE, the independent predictors were male gender, left ventricular end-diastolic volume index by CMR (CMR-LVEDVi), and >3 segments with midwall fibrosis on LGE (HR: 2.131, 95% CI: 1.231 3.690, P=0.007; HR: 3.161, 95% CI: 1.750 5.709, P < 0.001; and HR: 1.693, 95% CI: 1.084 2.644, P = 0.021, respectively). A composite clinical and CMR-based risk score provided a net reclassification improvement of 63.7% (P < 0.001) for MAACE occurrence when added to the model based on SOC evaluation. These findings were confirmed in the validation cohort. Conclusion In a large multicentre, multivendor cohort registry reflecting daily clinical practice in NICM work-up, a composite clinical and CMR-based risk score provides incremental prognostic value beyond SOC evaluation, which may have impact on the indication of implantable cardioverter-defibrillator implantation.

引用

页码：1072 / 1083

页数：12

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