Combination of late gadolinium enhancement and genotype improves prediction of prognosis in non‐ischaemic dilated cardiomyopathy

Mirelis, J. González; Escobar-López, Luis; Ochoa, Juan Pablo; Espinosa, María Ángeles; Villacorta, Eduardo; Navarro, Marina; Casas, G; Ayestarán, Nerea Mora; Barriales‐Villa, Roberto; Mogollón-Jiménez, María Victoria; García‐Pinilla, José Manuel; García‐Granja, Pablo Elpidio; Climent, Vicente; Palomino-Doza, Julián; García‐Álvarez, Ana; Álvarez-Barredo, María; Borrego, Eva Cabrera; Ripoll‐Vera, Tomás; Peña-Peña, María Luisa; Rodríguez-González, Elena; Gallego‐Delgado, María; Carrillo, J. González; Fernandez-Avila, Ana Isabel; Palomares, José F. Rodríguez; Brugada, Ramón; Bayés‐Genís, Antoni; Domínguez, Fernándo; García‐Pavía, Pablo

doi:10.1002/ejhf.2514

Cited by 19 publications

(13 citation statements)

References 30 publications

(58 reference statements)

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“…In regard to addressing the aforementioned dispute, Mirelis et al conducted a cohort study in which they demonstrated that the combination of late gadolinium enhancement from cardiac magnetic resonance (CMR) and positive genotype was useful in predicting SCD risk in patients with NICM and thus capable of stratifying the most qualified patients who benefit the most from primary prevention ICD therapy in this population. However, because CMR and genetic laboratories are time-consuming and hardly available in most healthcare institutions, as well as the restricted usage of gadolinium contrast in patients with end-stage renal disease, NT-pro BNP is still preferable to be used 17 35. Thus, more cohort studies evaluating the predictive efficacy of NT-pro BNP in ICM and NICM are highly needed to better understand the role of NT-pro BNP in stratifying patients with HFrEF who would benefit the most from ICD implantation for primary prevention.…”

Section: Discussionmentioning

confidence: 99%

Role of N-terminal pro-B type natriuretic peptide as a predictor of poor outcomes in patients with HFrEF receiving primary prevention implantable cardioverter-defibrillator therapy: a systematic review and dose–response meta-analysis

et al. 2023

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IntroductionSeveral studies have demonstrated that combining left ventricular ejection fraction and New York Heart Association functional class is insufficient for predicting risk of appropriate implantable cardioverter-defibrillator (ICD) shock in primary prevention candidates. Hence, our aim was to assess the relationship between N-terminal pro-B type natriuretic peptide (NT-pro BNP) along with appropriate ICD shock and all-cause mortality in order to improve the stratification process of patients with heart failure with reduced ejection fraction (HFrEF) being considered for primary preventive ICD therapy.MethodsA systematic literature search from several databases was conducted up until 9 June 2022. Studies were eligible if they investigated the relationship of NT-pro BNP with all-cause mortality and appropriate ICD shock.ResultsThis meta-analysis comprised nine studies with a total of 5117 participants. Our study revealed that high levels of NT-pro BNP were associated with all-cause mortality (HR=2.12 (95% CI=1.53 to 2.93); p<0.001, I2=78.1%, p<0.001 for heterogeneity) and appropriate ICD shock (HR=1.71 (95% CI=1.18 to 2.49); p<0.001, I2=43.4%, p=0.102 for heterogeneity). The adjusted HR for all-cause mortality and appropriate ICD shock increased by approximately 3% and 5%, respectively per 100 pg/mL increment pursuant to concentration–response model (Pnon-linearity<0.001). The curves became steeper after NT-pro BNP reached its inflection point (3000 pg/mL).ConclusionA positive concentration-dependent association between elevated NT-pro BNP levels along with the risk of all-cause mortality and appropriate ICD shock was found in patients with HFrEF with ICD.PROSPERO registration numberCRD42022339285.

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Section: Discussionmentioning

confidence: 99%

Role of N-terminal pro-B type natriuretic peptide as a predictor of poor outcomes in patients with HFrEF receiving primary prevention implantable cardioverter-defibrillator therapy: a systematic review and dose–response meta-analysis

et al. 2023

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“…In individuals without a high-risk genotype and an LVEF ≥ 35%, the use of LGE on CMR imaging becomes an essential tool for risk assessment [127]. It is recommended that genetic testing, encompassing at least the PLN, LMNA, FLNC, and RBM20 genes, be conducted for patients with DCM and atrioventricular (AV) conduction delay before the age of 50, or if a family history of SCD in a first-degree relative is present [122].…”

Section: Arrhythmic Risk Stratificationmentioning

confidence: 99%

The Role of Genetics in the Management of Heart Failure Patients

Palmieri,

D’Ambrosio,

Correale

et al. 2023

IJMS

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Over the last decades, the relevance of genetics in cardiovascular diseases has expanded, especially in the context of cardiomyopathies. Its relevance extends to the management of patients diagnosed with heart failure (HF), given its capacity to provide invaluable insights into the etiology of cardiomyopathies and identify individuals at a heightened risk of poor outcomes. Notably, the identification of an etiological genetic variant necessitates a comprehensive evaluation of the family lineage of the affected patients. In the future, these genetic variants hold potential as therapeutic targets with the capability to modify gene expression. In this complex setting, collaboration among cardiologists, specifically those specializing in cardiomyopathies and HF, and geneticists becomes paramount to improving individual and family health outcomes, as well as therapeutic clinical results. This review is intended to offer geneticists and cardiologists an updated perspective on the value of genetic research in HF and its implications in clinical practice.

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“…In this issue of the Journal, Mirelis et al 4 report data from a large retrospective study incorporating rare variant genetics with late gadolinium enhancement (LGE) CMR for the prediction of end-stage heart failure and malignant ventricular arrhythmia in patients with DCM. The curation of 600 DCM cases with previous CMR and genetic testing from several centres in Spain is to be commended.…”

Section: This Article Refers To 'Combination Of Late Gadolinium Enhan...mentioning

confidence: 99%

Dilated cardiomyopathy – details make the difference

McGurk

Halliday

2022

European J of Heart Fail

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Combination of late gadolinium enhancement and genotype improves prediction of prognosis in non‐ischaemic dilated cardiomyopathy

Cited by 19 publications

References 30 publications

Role of N-terminal pro-B type natriuretic peptide as a predictor of poor outcomes in patients with HFrEF receiving primary prevention implantable cardioverter-defibrillator therapy: a systematic review and dose–response meta-analysis

Role of N-terminal pro-B type natriuretic peptide as a predictor of poor outcomes in patients with HFrEF receiving primary prevention implantable cardioverter-defibrillator therapy: a systematic review and dose–response meta-analysis

The Role of Genetics in the Management of Heart Failure Patients

Dilated cardiomyopathy – details make the difference

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