Arrhythmias & electrophysiologyCohort study
Left ventricular ejection fraction and myocardial fibrosis in sudden cardiac death
- Retrospective cohort study
- population-based
- autopsy-verified
Authors' conclusion
The proportion of SCD subjects with LVEF ≤35% is low, and the prevalence of myocardial fibrosis is high. The LVEF has a weak correlation with the extent of myocardial fibrosis.
Study context
- Population
- Consecutive autopsy-verified sudden cardiac death (SCD) victims, Northern Finland, 1998–2017 (Fingesture study)716 with pre-mortem left ventricular ejection fraction (LVEF)
- Participants
- 5,869 victims
- Exposure
- Normal LVEF vs Mildly reduced LVEF vs Severely reduced LVEF
- Normal LVEFn = 449
- Mildly reduced LVEFn = 157
- Severely reduced LVEFn = 110
- Outcome
- Spectrum of pre-SCD LVEF and its association with extent of myocardial fibrosis at autopsy
- Follow-up
- LVEF recorded median 2 years (IQR 1-5) prior to SCD
Main finding
As reported in the abstract
Pre-SCD LVEF distribution and correlation with myocardial fibrosis
- Correlation of fibrosis extent with LVEF (Spearman's ρ), CI 0.141-0.285, P < 0.001
- 0.21
Observational data: associations, not effects.
Further findings
Myocardial fibrosis at autopsy
- Substantial fibrosis (n = 140)
- 19.6%
- Moderate fibrosis (n = 386)
- 53.8%
- Mild fibrosis (n = 158)
- 22.1%
- No fibrosis (n = 32)
- 4.5%
LVEF ≤35% among those with substantial fibrosis
- Substantial fibrosis with LVEF ≤35%
- 21.4%
Original publication
Left ventricular ejection fraction and myocardial fibrosis in sudden cardiac death. Europace. Published 28 November 2025. doi:10.1093/europace/euaf306
Summarised from the published abstract; every number is checked against it