Arrhythmias & electrophysiology
Extracellular volume fraction improves risk-stratification for ventricular arrhythmias and sudden death in non-ischaemic cardiomyopathy
Primary result · Primary endpoint (VA/SD)Result — go to the resultHazard ratio 14.1Authors' conclusion
Comprehensive CMR evaluation in NICM showed that ECV was the only parameter with an independent and strong predictive value for VA/SD, on top of LGE and LVEF. A risk-stratification model based on LGE, LVEF ≤ 35% and ECV ≥ 30% achieved an excellent predictive ability for VA/SD.
Study context
- Population
- Consecutive patients with non-ischaemic cardiomyopathy (NICM) undergoing cardiac magnetic resonance (CMR)618 with extracellular volume (ECV) available
- Participants
- 703 patients
- Comparison
- CMR parameters for prediction of ventricular arrhythmias (VA)/SD
- Primary endpoint
- Appropriate ICD therapies, sustained VT, resuscitated cardiac arrest and SD
- Follow-up
- Median 21 months
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Primary result
Primary endpoint (VA/SD)
Hazard ratio
14.1
P = 0.01
As reported in the abstract
- Primary endpoint events, overall
- 14 (2%)
- Primary endpoint events, patients with ECV available
- 11 (2%)
- Mean ECV significantly associated with primary endpoint; best cut-off
- 30%
Further findings
ECV ≥ 30% in subgroups (late gadolinium enhancement (LGE)+; Left ventricular ejection fraction (LVEF) ≤ 35%)
- ECV ≥ 30% discriminated arrhythmic risk among LGE+ cases and among those with LVEF ≤ 35%
Risk model (LGE, LVEF ≤ 35%, ECV ≥ 30%)
- Harrell's C
- 0.82
- Risk reclassified vs LVEF ≤ 35% alone
- 32%
Original publication
Extracellular volume fraction improves risk-stratification for ventricular arrhythmias and sudden death in non-ischaemic cardiomyopathy. Eur Heart J Cardiovasc Imaging. Published 25 July 2022. doi:10.
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