Heart failure & cardiomyopathies
Inflammation on Endomyocardial Biopsy Predicts Risk of Major Adverse Cardiovascular Events (MACE) in Undefined Left Ventricular Arrhythmogenic Cardiomyopathy
Authors' conclusion
Presentation with malignant VA or AM associates with MACE in ULVACM patients.
Study context
- Population
- Patients with undefined left ventricle (LV) arrhythmogenic cardiomyopathy (new-onset ventricular arrhythmia (VA), nonischemic LGE limited to LV, LVEF ≥40%)
- Participants
- 313 patients
- Exposure
- Predictors of MACE in undefined left ventricular arrhythmogenic cardiomyopathy (ULVACM)
- Outcome
- MACE:
- Cardiac death
- Heart transplantation
- Malignant VA
- Follow-up
- 60 months after clinical presentation
Methodological detailsmulticentre registry
- Multicentre registry
Main finding
As reported in the abstract
MACE · 58-month median follow-up
Hazard ratio (95% CI)P value
Presentation with malignant VAmultivariable
2.8(1.4–5.5)
P = 0.003EMB-proven active myocardial inflammationmultivariable
3.9(1.9–7.5)
P < 0.001Immunosuppressive therapymultivariable; MACE at 60 months
0.10(0.05–0.40)
P < 0.001- MACE in whole cohort
- 93 of 313 (30%)
Observational data: associations, not effects.
Further findings
Diagnostic yield of next generation sequencing (NGS) and endomyocardial biopsy (EMB)
- Underwent NGS
- 160 (51%)
- Underwent EMB
- 198 (63%)
- P/LP cardiomyopathy variants on NGS
- 25 of 160 (16%)
- Active myocardial inflammation on EMB
- 102 of 198 (52%)
- AM patients receiving immunosuppressive therapy
- 47 (46%)
Original publication
Inflammation on Endomyocardial Biopsy Predicts Risk of MACE in Undefined Left Ventricular Arrhythmogenic Cardiomyopathy. JACC Clin Electrophysiol. Published 18 January 2023. doi:10.
Summarised from the published abstract; every number is checked against it