Heart failure & cardiomyopathies
Late Gadolinium Enhancement and the Risk of Ventricular Arrhythmias and Sudden Death in New York Heart Association (NYHA) Class I Patients with Non-Ischaemic Cardiomyopathy
Authors' conclusion
Patients with NICM in NYHA class I are not necessarily at low risk of VA and SD. Actually, LGE+ NYHA class I patients have a high risk.
Study context
- Population
- Patients with non-ischaemic cardiomyopathy (NICM) who underwent CMR33% in NYHA class I
- Participants
- 698 patients
- Exposure
- NYHA class I vs NYHA class II-III
- Outcome
- Appropriate implantable cardioverter defibrillator (ICD) therapies, sustained VT, resuscitated cardiac arrest and sudden death
- Follow-up
- Median 31 months
Methodological detailstwo hospitals
- Two hospitals
Main finding
As reported in the abstract
P = 0.62
- Primary endpoint occurred overall in 57 patients (8%)
- 57 (8%)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR | P value |
|---|---|---|
| Primary endpoint by LGE status (subgroup)LGE+ NYHA class I vs LGE+ NYHA class II-III · similar cumulative incidence | P = 0.92 | |
| Primary endpoint by LGE status (subgroup)LGE+ NYHA class I vs LGE- NYHA class II-III · significantly higher risk in LGE+ NYHA class I | P < 0.001 | |
| HF hospitalization, heart transplant, LV assist device implant or HF death (secondary endpoint) | 3.2 | P = 0.001 |
Predictors of primary outcome
- Late gadolinium enhancement (LGE) was the only independent predictor of the primary outcome in both NYHA class I and NYHA class II-III
Original publication
Late Gadolinium Enhancement and the Risk of Ventricular Arrhythmias and Sudden Death in NYHA Class I Patients with Non-Ischaemic Cardiomyopathy. Eur J Heart Fail. Published 22 February 2023. doi:10.
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