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Late Gadolinium Enhancement in Patients with Nonischemic Dilated Cardiomyopathy.

One-third of all patients with heart failure have nonischemic dilated cardiomyopathy (NIDM). Five-year mortality from NIDM is as high as 20% with sudden cardiac death (SCD) as the cause in 30% of the deaths. Currently, the left ventricular ejection fraction (LVEF) is used as the main criteria to ris...

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Published in:Pacing & Clinical Electrophysiology Vol. 39; no. 7; pp. 731 - 748
Main Authors: MEMON, SARFARAZ, GANGA, HARSHA V., KLUGER, JEFFREY
Format: diagnostic images research systematic review tables/charts Journal Article
Published: Wiley-Blackwell Jul2016
Online Access:View this record in EBSCOhost
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      dt: Jul2016
      vid: 39
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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      tig:
        atl: Late Gadolinium Enhancement in Patients with Nonischemic Dilated Cardiomyopathy.
      aug:
        au:
          MEMON, SARFARAZ
          GANGA, HARSHA V.
          KLUGER, JEFFREY
        affil: Division of Cardiology, Hartford Hospital, Hartford Connecticut
      sug:
        subj:
          Cardiomyopathy, Dilated
          Ventricular Ejection Fraction
          Ventricular Function, Left
          Defibrillators, Implantable
          Risk Factors
          Human
          Systematic Review
          PubMed
      ab: One-third of all patients with heart failure have nonischemic dilated cardiomyopathy (NIDM). Five-year mortality from NIDM is as high as 20% with sudden cardiac death (SCD) as the cause in 30% of the deaths. Currently, the left ventricular ejection fraction (LVEF) is used as the main criteria to risk stratify patients requiring an implantable cardioverter defibrillator (ICD) to prevent SCD. However, LVEF does not necessarily reflect myocardial propensity for electrical instability leading to ventricular tachycardia (VT) or ventricular fibrillation (VF). Due to the differential risk in various subgroups of patients for arrhythmic death, it is important to identify appropriate patients for ICD implantation so that we can optimize healthcare resources and avoid the complications of ICDs in individuals who are unlikely to benefit. We performed a systematic search and review of clinical trials of NIDM and the use of ICDs and cardiac magnetic resonance imaging with late gadolinium enhancement (LGE) for risk stratification. LGE identifies patients with NIDM who are at high risk for SCD and enables optimized patient selection for ICD placement, while the absence of LGE may reduce the need for ICD implantation in patients with NIDM who are at low risk for future VF/VT or SCD.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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