A structural abnormality on cardiac magnetic resonance imaging (CMR) may be a predictor of major adverse cardiac events (MACE) in patients with nonsustained ventricular tachycardia (NSVT) and ventricular tachycardia (VT)/sudden cardiac death (SCD), according to study results intended to be presented at the annual meeting of the American College of Cardiology (ACC.20).
According to researchers, evidence is lacking to support a clinical impact of CMR in patients with ventricular arrhythmias. The objective of this study was to examine the diagnostic and prognostic values of CMR in patients with ventricular arrhythmias.
In this study, 651 consecutive patients (ages, 54±15; 61% men) referred to CMR for ventricular arrhythmia were divided into 2 groups, according to the presence of NSVT (53%) or sustained VT/aborted SCD (47%). MACE was a composite of cardiovascular death, a need for heart transplantation or left ventricular assist device, and recurrent VT/ventricular fibrillation needing therapy.
In this cohort, the mean left ventricular ejection fraction was 54±13%, and late gadolinium enhancement (LGE) was present in 39% of patients (mean, 9.5±8%). A structurally abnormal heart — defined by LGE, abnormalities in wall motion, or impaired systolic function — was observed in 52% of patients (n=336). A change in diagnostic impression based on CMR took place for 27% of patients with NSVT vs 40% of patients with VT/SCD (P <.001). A total of 122 patients experienced a MACE during the follow-up period (median, 3.6 years). Structural abnormality detected on CMR was found to be an independent predictor of MACE (hazard ratio, 3.65; 95% CI, 2.09-6.27; P <.001).
”The presence of a structural abnormality on CMR is a predictor of adverse cardiac events,” concluded the study authors.
Ge Y, Antiochos P, Qamar I, et al. Diagnostic impact and prognostic value of cardiac MRI in patients with ventricular arrhythmias. Intended to be presented at: American College of Cardiology’s 69th Annual Scientific Session; March 28-30, 2020; Chicago, IL. Presentation 916-06.