Impact of viability, ischemia, scar tissue, and revascularization on outcome after aborted sudden death

Burg, Alida E Borger van der; Bax, Jeroen J.; Boersma, Eric; Pauwels, E. K. J.; Wall, E. E. van der; Schalij, M.J.

doi:10.1016/j.accreview.2004.02.065

Cited by 26 publications

(38 citation statements)

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“…However, LVEF impairment is a well established prognostic predictor for the clinical outcome of patients with CAD. [16][17][18] In prior studies of our group, we found significantly decreased amounts of EAT in patients with impaired LVEF due to ischemic or non-ischemic cardiomyopathy in comparison to healthy controls, 19 suggesting a complex interaction of EAT and CAD.…”

supporting

confidence: 49%

Impact of Functional, Morphological and Clinical Parameters on Epicardial Adipose Tissue in Patients With Coronary Artery Disease

Doesch

Haghi

Süselbeck

et al. 2012

Circ J

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supporting

confidence: 49%

Impact of Functional, Morphological and Clinical Parameters on Epicardial Adipose Tissue in Patients With Coronary Artery Disease

Doesch

Haghi

Süselbeck

et al. 2012

Circ J

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“…Total HE mass was found to be significantly higher among ICM and DCM patients suffering from appropriate ICD therapy, SCA, or SCD. 23 subsequently demonstrated that the extent of fixed perfusion defects on single photon emission computed tomography imaging predicted future arrhythmic events and death in patients with a history of survived SCA. Following these observations, Bello et al 24 performed a sentinel study demonstrating the direct measurement of myocardial scar extent by LGE-CMR and its correlation with the rate of VT inducibility at electrophysiological testing.…”

Section: Discussionmentioning

confidence: 98%

Prediction of Arrhythmic Events in Ischemic and Dilated Cardiomyopathy Patients Referred for Implantable Cardiac Defibrillator

Gao

Yee

Gula

et al. 2012

Circ: Cardiovascular Imaging

188

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Background-Scar signal quantification using late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) identifies patients at higher risk of future events, both in ischemic cardiomyopathy (ICM) and nonischemic dilated cardiomyopathy (DCM). However, the ability of scar signal burden to predict events in such patient groups at the time of referral for implantable cardioverter-defibrillator (ICD) has not been well explored. This study evaluates the predictive use of multiple scar quantification measures in ICM and DCM patients being referred for ICD. Methods and Results-One hundred twenty-four consecutive patients referred for ICD therapy (59 with ICM and 65 with DCM) underwent a standardized LGE-CMR protocol with blinded, multithreshold scar signal quantification and, for those with ICM, peri-infarct signal quantification. Patients were followed prospectively for the primary combined outcome of appropriate ICD therapy, survived cardiac arrest, or sudden cardiac death. At a mean follow-up of 632±262 days, 18 patients (15%) had suffered the primary outcome. Total scar was significantly higher among those suffering a primary outcome, a relationship maintained within each cardiomyopathy cohort (P<0.01 for all comparisons). Total scar was the strongest independent predictor of the primary outcome and demonstrated a negative predictive value of 86%. In the ICM subcohort, peri-infarct signal showed only a nonsignificant trend toward elevation among those having a primary end point. Conclusions-Myocardial

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“…In a study of 153 survivors of resuscitated sudden death who subsequently underwent stress-rest perfusion imaging, LVEF and the extent of myocardial scar were shown to be significant predictors of recurrent ventricular arrhythmias and/or all-cause death. 14 Paganelli et al investigated the effect of residual myocardial ischemia on inducible ventricular arrhythmias during programmed stimulation. In 90 survivors of MI, they found that residual myocardial ischemia on SPECT 201 Tl imaging was associated with a 1.6-fold increase in the risk of inducible ventricular arrhythmias during electrophysiology testing.…”

Section: Discussionmentioning

confidence: 99%

“…Although single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) has been shown to identify patients at high risk of cardiovascular events and cardiovascular mortality, [11][12][13] including those resuscitated from SCD, 14 it remains unknown whether it can identify patients with CAD at risk for de novo SCD. The goal of this study is to determine whether SPECT MPI can identify patients with CAD at increased risk of SCD.…”

Section: Editorial See P 175 Clinical Perspective See P 188mentioning

confidence: 99%

Single-Photon Emission Computed Tomography Myocardial Perfusion Defects Are Associated With an Increased Risk of All-Cause Death, Cardiovascular Death, and Sudden Cardiac Death

Piccini

Horton

Shaw

et al. 2008

Circ: Cardiovascular Imaging

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Background— Single-photon emission computed tomography myocardial perfusion imaging defects are associated with increased all-cause mortality and cardiovascular death. However, it is unknown whether single-photon emission computed tomography myocardial perfusion imaging can identify patients at increased risk of sudden cardiac death (SCD). Methods and Results— We analyzed a cohort of 6383 patients with angiographically documented coronary artery disease who underwent single-photon emission computed tomography imaging. Cox proportional hazards modeling was used to examine the relationship between patient characteristics and SCD. Among patients who died, the median time to SCD was 2.7 years (25 th , 75 th percentiles 0.9, 4.9, respectively). The incidence of SCD was 3.4% (n=215) over 6.1 years (25 th , 75 th percentiles 3.7, 9.2, respectively) of follow-up. Patients with SCD had more severe heart failure symptoms, greater comorbidity (Charlson index), and higher summed stress perfusion scores (all P <0.001). After adjusting for left ventricular ejection fraction and other clinical factors in the multivariable model, the summed stress perfusion score (fixed plus reversible defects) remained significantly associated with the occurrence of SCD: summed stress perfusion score (hazard ratios per 3 U: 1.16 [95% CI, 1.08 to 1.25], P <0.001), left ventricular ejection fraction (hazard ratios per 5 U: 0.90 [95% CI, 0.85 to 0.95], P <0.001), and Charlson index (hazard ratios 1.35 [95% CI, 1.23 to 1.49], P <0.001). Conclusions— Myocardial perfusion imaging is a significant predictor of SCD and provides information independent of clinical history and left ventricular ejection fraction. Gated single-photon emission computed tomography imaging, which evaluates both myocardial perfusion and function, may represent a more effective means of risk stratification than solitary left ventricular ejection fraction determination and should be evaluated in prospective trials.

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Impact of viability, ischemia, scar tissue, and revascularization on outcome after aborted sudden death

Cited by 26 publications

References 0 publications

Impact of Functional, Morphological and Clinical Parameters on Epicardial Adipose Tissue in Patients With Coronary Artery Disease

Impact of Functional, Morphological and Clinical Parameters on Epicardial Adipose Tissue in Patients With Coronary Artery Disease

Prediction of Arrhythmic Events in Ischemic and Dilated Cardiomyopathy Patients Referred for Implantable Cardiac Defibrillator

Single-Photon Emission Computed Tomography Myocardial Perfusion Defects Are Associated With an Increased Risk of All-Cause Death, Cardiovascular Death, and Sudden Cardiac Death

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