Sudden Cardiac Death Prediction in Arrhythmogenic Right Ventricular Cardiomyopathy-Reference-Cited by-同舟云学术

Sudden Cardiac Death Prediction in Arrhythmogenic Right Ventricular Cardiomyopathy

Published:2021-01 Issue:1 Volume:14 Page:
ISSN:1941-3149
Container-title:Circulation: Arrhythmia and Electrophysiology
language:en
Short-container-title:Circ: Arrhythmia and Electrophysiology

Author:

Cadrin-Tourigny Julia¹²^ORCID,Bosman Laurens P.³⁴^ORCID,Wang Weijia¹,Tadros Rafik²^ORCID,Bhonsale Aditya¹,Bourfiss Mimount⁴,Lie Øyvind H.⁵,Saguner Ardan M.⁶^ORCID,Svensson Anneli⁷^ORCID,Andorin Antoine²^ORCID,Tichnell Crystal¹,Murray Brittney¹^ORCID,Zeppenfeld Katja⁸^ORCID,van den Berg Maarten P.⁹^ORCID,Asselbergs Folkert W.³⁴¹⁰^ORCID,Wilde Arthur A.M.¹¹¹²^ORCID,Krahn Andrew D.¹³^ORCID,Talajic Mario²^ORCID,Rivard Lena²,Chelko Stephen¹¹⁴^ORCID,Zimmerman Stefan L.¹⁵^ORCID,Kamel Ihab R.¹⁵,Crosson Jane E.¹,Judge Daniel P.¹^ORCID,Yap Sing-Chien¹⁶^ORCID,Van der Heijden Jeroen F.⁴,Tandri Harikrishna¹^ORCID,Jongbloed Jan D.H.¹⁷,van Tintelen J. Peter³¹⁸¹⁹^ORCID,Platonov Pyotr G.¹^ORCID,Duru Firat¹^ORCID,Haugaa Kristina H.¹^ORCID,Khairy Paul¹^ORCID,Hauer Richard N.W.¹,Calkins Hugh¹^ORCID,te Riele Anneline S.J.M.¹,James Cynthia A.¹^ORCID

Affiliation:

1. Department of Medicine, Division of Cardiology (J.C.-T., W.W., A.B., C.T., B.M., S.C., J.E.C., D.P.J., H.T., H.C., C.A.J.), Johns Hopkins Hospital, Baltimore, MD.

2. Cardiovascular Genetics Center, Montreal Heart Institute, Université de Montréal, Canada (J.C.-T., R.T., A.A., M.T., L.R., P.K.).

3. Netherlands Heart Institute (L.P.B., F.W.A., J.P.v.T., R.N.W.H., A.S.J.M.t.R.).

4. Department of Cardiology (L.P.B., M.B., F.W.A., J.F.V.d.H., A.S.J.M.t.R.), University Medical Center Utrecht, Utrecht University, the Netherlands.

5. Department of Cardiology and Research group for Cardiogenetics and Sudden Cardiac Death, Oslo University Hospital, Rikshospitalet, Norway (Ø.H.L., K.H.H.).

6. Department of Cardiology, University Heart Center Zurich, Switzerland (A.M.S., F.D.).

7. Department of Cardiology and Department of Medical & Health Sciences, Linköping University, Swede (A.S.).

8. Department of Cardiology, Leiden University Medical Center (K.Z.).

9. Department of Cardiology (M.P.v.d.B.), University Medical Center Groningen, University of Groningen, the Netherlands.

10. Institute of Cardiovascular Science & Institute of Health Informatics, Faculty of Population Health Sciences, University College London, United Kingdom (F.W.A.).

11. Amsterdam UMC, University of Amsterdam, Heart Center (A.A.M.W.).

12. Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, the Netherlands (A.A.M.W.).

13. Division of Cardiology, University of British Columbia, Vancouver, Canada (A.D.K.).

14. Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee (S.C.).

15. The Russell H. Morgan Department of Radiology and Radiological Science (S.L.Z., I.R.K.), Johns Hopkins Hospital, Baltimore, MD.

16. Department of Cardiology, Erasmus Medical Center, Rotterdam (S.-C.Y.).

17. Department of Genetics (J.D.H.J.), University Medical Center Groningen, University of Groningen, the Netherlands.

18. Department of Genetics (J.P.v.T.), University Medical Center Utrecht, Utrecht University, the Netherlands.

19. Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, the Netherlands (J.P.v.T.).

Abstract

Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with ventricular arrhythmias (VA) and sudden cardiac death (SCD). A model was recently developed to predict incident sustained VA in patients with ARVC. However, since this outcome may overestimate the risk for SCD, we aimed to specifically predict life-threatening VA (LTVA) as a closer surrogate for SCD. Methods: We assembled a retrospective cohort of definite ARVC cases from 15 centers in North America and Europe. Association of 8 prespecified clinical predictors with LTVA (SCD, aborted SCD, sustained, or implantable cardioverter-defibrillator treated ventricular tachycardia >250 beats per minute) in follow-up was assessed by Cox regression with backward selection. Candidate variables included age, sex, prior sustained VA (≥30s, hemodynamically unstable, or implantable cardioverter-defibrillator treated ventricular tachycardia; or aborted SCD), syncope, 24-hour premature ventricular complexes count, the number of anterior and inferior leads with T-wave inversion, left and right ventricular ejection fraction. The resulting model was internally validated using bootstrapping. Results: A total of 864 patients with definite ARVC (40±16 years; 53% male) were included. Over 5.75 years (interquartile range, 2.77–10.58) of follow-up, 93 (10.8%) patients experienced LTVA including 15 with SCD/aborted SCD (1.7%). Of the 8 prespecified clinical predictors, only 4 (younger age, male sex, premature ventricular complex count, and number of leads with T-wave inversion) were associated with LTVA. Notably, prior sustained VA did not predict subsequent LTVA ( P =0.850). A model including only these 4 predictors had an optimism-corrected C-index of 0.74 (95% CI, 0.69–0.80) and calibration slope of 0.95 (95% CI, 0.94–0.98) indicating minimal over-optimism. Conclusions: LTVA events in patients with ARVC can be predicted by a novel simple prediction model using only 4 clinical predictors. Prior sustained VA and the extent of functional heart disease are not associated with subsequent LTVA events.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Reference33 articles.

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