Extracellular volume is an independent predictor of arrhythmic burden in dilated cardiomyopathy

2021
journal article
article
24
cris.lastimport.wos2024-04-09T19:05:34Z
dc.abstract.enThe current stratification of arrhythmic risk in dilated cardiomyopathy (DCM) is sub-optimal. Cardiac fibrosis is involved in the pathology of arrhythmias; however, the relationship between cardiovascular magnetic resonance (CMR) derived extracellular volume (ECV) and arrhythmic burden (AB) in DCM is unknown. This study sought to evaluate the presence and extent of replacement and interstitial fibrosis in DCM and to compare the degree of fibrosis between DCM patients with and without AB. This is a prospective, single-center, observational study. Between May 2019 and September 2020, 102 DCM patients underwent CMR T1 mapping. 99 DCM patients (88 male, mean age 45.2 ± 11.8 years, mean EF 29.7 ± 10%) composed study population. AB was defined as the presence of VT or a high burden of PVCs. There were 41 (41.4%) patients with AB and 58 (58.6%) without AB. Replacement fibrosis was assessed with late gadolinium enhancement (LGE), whereas interstitial fibrosis with ECV. Overall, LGE was identified in 41% of patients. There was a similar distribution of LGE (without AB 50% vs. with AB 53.7%; p = 0.8) and LGE extent (without AB 4.36 ± 5.77% vs. with AB 4.68 ± 3.98%; p = 0.27) in both groups. ECV at nearly all myocardial segments and a global ECV were higher in patients with AB (global ECV: 27.9 ± 4.9 vs. 30.3 ± 4.2; p < 0.02). Only indexed left ventricular end-diastolic diameter (HR 1.1, 95%CI 1.0–1.2; p < 0.02) and global ECV (HR 1.12, 95%CI 1.0–1.25; p < 0.02) were independently associated with AB. The global ECV cut-off value of 31.05% differentiated both groups (AUC 0.713; 95%CI 0.598–0.827; p < 0.001). Neither qualitative nor quantitative LGE-based assessment of replacement fibrosis allowed for the stratification of DCM patients into low or high AB. Interstitial fibrosis, expressed as ECV, was an independent predictor of AB in DCM. Incorporation of CMR parametric indices into decision-making processes may improve arrhythmic risk stratification in DCM.
dc.affiliationWydział Lekarski : Instytut Kardiologiipl
dc.cm.date2021-12-29
dc.cm.id106828
dc.cm.idOmegaUJCM36e63164f799440dbfffc6d8465a2ed5pl
dc.contributor.authorRubiś, Paweł - 320209
dc.contributor.authorDziewięcka, Ewa - 175977
dc.contributor.authorBanyś, Robert Paweł
dc.contributor.authorUrbańczyk-Zawadzka, Małgorzata
dc.contributor.authorKrupiński, Maciej
dc.contributor.authorMielnik, Małgorzata
dc.contributor.authorŁach, Jacek
dc.contributor.authorZąbek, Andrzej
dc.contributor.authorWiśniowska-Śmiałek, Sylwia - 358423
dc.contributor.authorPodolec, Piotr - 133185
dc.contributor.authorKarabinowska-Małocha, Aleksandra - 206192
dc.contributor.authorHolcman, Katarzyna - 148503
dc.contributor.authorGarlitski, Ann C.
dc.date.accession2021-12-22pl
dc.date.accessioned2021-12-29T21:18:02Z
dc.date.available2021-12-29T21:18:02Z
dc.date.issued2021pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.points140
dc.description.versionostateczna wersja wydawcy
dc.description.volume11pl
dc.identifier.articleid24000pl
dc.identifier.doi10.1038/s41598-021-03452-zpl
dc.identifier.eissn2045-2322pl
dc.identifier.issn2045-2322pl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/286278
dc.identifier.weblinkhttps://www.nature.com/articles/s41598-021-03452-zpl
dc.languageengpl
dc.language.containerengpl
dc.pbn.affiliationDziedzina nauk medycznych i nauk o zdrowiu : nauki medyczne
dc.rightsUdzielam licencji. Uznanie autorstwa 4.0 Międzynarodowa
dc.rights.licenceCC-BY
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/legalcode.pl
dc.share.typeOtwarte czasopismo
dc.source.integratorfalse
dc.subtypeArticlepl
dc.titleExtracellular volume is an independent predictor of arrhythmic burden in dilated cardiomyopathypl
dc.title.journalScientific Reportspl
dc.typeJournalArticlepl
dspace.entity.typePublication
cris.lastimport.wos
2024-04-09T19:05:34Z
dc.abstract.en
The current stratification of arrhythmic risk in dilated cardiomyopathy (DCM) is sub-optimal. Cardiac fibrosis is involved in the pathology of arrhythmias; however, the relationship between cardiovascular magnetic resonance (CMR) derived extracellular volume (ECV) and arrhythmic burden (AB) in DCM is unknown. This study sought to evaluate the presence and extent of replacement and interstitial fibrosis in DCM and to compare the degree of fibrosis between DCM patients with and without AB. This is a prospective, single-center, observational study. Between May 2019 and September 2020, 102 DCM patients underwent CMR T1 mapping. 99 DCM patients (88 male, mean age 45.2 ± 11.8 years, mean EF 29.7 ± 10%) composed study population. AB was defined as the presence of VT or a high burden of PVCs. There were 41 (41.4%) patients with AB and 58 (58.6%) without AB. Replacement fibrosis was assessed with late gadolinium enhancement (LGE), whereas interstitial fibrosis with ECV. Overall, LGE was identified in 41% of patients. There was a similar distribution of LGE (without AB 50% vs. with AB 53.7%; p = 0.8) and LGE extent (without AB 4.36 ± 5.77% vs. with AB 4.68 ± 3.98%; p = 0.27) in both groups. ECV at nearly all myocardial segments and a global ECV were higher in patients with AB (global ECV: 27.9 ± 4.9 vs. 30.3 ± 4.2; p < 0.02). Only indexed left ventricular end-diastolic diameter (HR 1.1, 95%CI 1.0–1.2; p < 0.02) and global ECV (HR 1.12, 95%CI 1.0–1.25; p < 0.02) were independently associated with AB. The global ECV cut-off value of 31.05% differentiated both groups (AUC 0.713; 95%CI 0.598–0.827; p < 0.001). Neither qualitative nor quantitative LGE-based assessment of replacement fibrosis allowed for the stratification of DCM patients into low or high AB. Interstitial fibrosis, expressed as ECV, was an independent predictor of AB in DCM. Incorporation of CMR parametric indices into decision-making processes may improve arrhythmic risk stratification in DCM.
dc.affiliationpl
Wydział Lekarski : Instytut Kardiologii
dc.cm.date
2021-12-29
dc.cm.id
106828
dc.cm.idOmegapl
UJCM36e63164f799440dbfffc6d8465a2ed5
dc.contributor.author
Rubiś, Paweł - 320209
dc.contributor.author
Dziewięcka, Ewa - 175977
dc.contributor.author
Banyś, Robert Paweł
dc.contributor.author
Urbańczyk-Zawadzka, Małgorzata
dc.contributor.author
Krupiński, Maciej
dc.contributor.author
Mielnik, Małgorzata
dc.contributor.author
Łach, Jacek
dc.contributor.author
Ząbek, Andrzej
dc.contributor.author
Wiśniowska-Śmiałek, Sylwia - 358423
dc.contributor.author
Podolec, Piotr - 133185
dc.contributor.author
Karabinowska-Małocha, Aleksandra - 206192
dc.contributor.author
Holcman, Katarzyna - 148503
dc.contributor.author
Garlitski, Ann C.
dc.date.accessionpl
2021-12-22
dc.date.accessioned
2021-12-29T21:18:02Z
dc.date.available
2021-12-29T21:18:02Z
dc.date.issuedpl
2021
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.points
140
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
11
dc.identifier.articleidpl
24000
dc.identifier.doipl
10.1038/s41598-021-03452-z
dc.identifier.eissnpl
2045-2322
dc.identifier.issnpl
2045-2322
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/286278
dc.identifier.weblinkpl
https://www.nature.com/articles/s41598-021-03452-z
dc.languagepl
eng
dc.language.containerpl
eng
dc.pbn.affiliation
Dziedzina nauk medycznych i nauk o zdrowiu : nauki medyczne
dc.rights
Udzielam licencji. Uznanie autorstwa 4.0 Międzynarodowa
dc.rights.licence
CC-BY
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/legalcode.pl
dc.share.type
Otwarte czasopismo
dc.source.integrator
false
dc.subtypepl
Article
dc.titlepl
Extracellular volume is an independent predictor of arrhythmic burden in dilated cardiomyopathy
dc.title.journalpl
Scientific Reports
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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