Aims: The aim of this registry was to evaluate the additional prognostic value of a composite cardiac magnetic resonance (CMR)-based risk score over standard-of-care (SOC) evaluation in a large cohort of consecutive unselected non-ischaemic cardiomyopathy (NICM) patients. Methods and results: In the DERIVATE registry (www.clinicaltrials.gov/registration: RCT#NCT03352648), 1000 (derivation cohort) and 508 (validation cohort) NICM patients with chronic heart failure (HF) and left ventricular ejection fraction [removed]3 segments with midwall fibrosis on late gadolinium enhancement (LGE) were the only independent predictors of all-cause mortality (HR: 1.036, 95% CI: 1.0117-1.056, P < 0.001 and HR: 2.077, 95% CI: 1.211-3.562, P = 0.008, respectively). For MAACE, the independent predictors were male gender, left ventricular end-diastolic volume index by CMR (CMR-LVEDVi), and >3 segments with midwall fibrosis on LGE (HR: 2.131, 95% CI: 1.231-3.690, P = 0.007; HR: 3.161, 95% CI: 1.750-5.709, P < 0.001; and HR: 1.693, 95% CI: 1.084-2.644, P = 0.021, respectively). A composite clinical and CMR-based risk score provided a net reclassification improvement of 63.7% (P < 0.001) for MAACE occurrence when added to the model based on SOC evaluation. These findings were confirmed in the validation cohort. Conclusion: In a large multicentre, multivendor cohort registry reflecting daily clinical practice in NICM work-up, a composite clinical and CMR-based risk score provides incremental prognostic value beyond SOC evaluation, which may have impact on the indication of implantable cardioverter-defibrillator implantation.

Guaricci, A., Masci, P., Muscogiuri, G., Guglielmo, M., Baggiano, A., Fusini, L., et al. (2021). CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Ischaemic dilated CardioMyopathy: an international Registry. EUROPACE, 23(7), 1072-1083 [10.1093/europace/euaa401].

CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Ischaemic dilated CardioMyopathy: an international Registry

Muscogiuri G;
2021

Abstract

Aims: The aim of this registry was to evaluate the additional prognostic value of a composite cardiac magnetic resonance (CMR)-based risk score over standard-of-care (SOC) evaluation in a large cohort of consecutive unselected non-ischaemic cardiomyopathy (NICM) patients. Methods and results: In the DERIVATE registry (www.clinicaltrials.gov/registration: RCT#NCT03352648), 1000 (derivation cohort) and 508 (validation cohort) NICM patients with chronic heart failure (HF) and left ventricular ejection fraction [removed]3 segments with midwall fibrosis on late gadolinium enhancement (LGE) were the only independent predictors of all-cause mortality (HR: 1.036, 95% CI: 1.0117-1.056, P < 0.001 and HR: 2.077, 95% CI: 1.211-3.562, P = 0.008, respectively). For MAACE, the independent predictors were male gender, left ventricular end-diastolic volume index by CMR (CMR-LVEDVi), and >3 segments with midwall fibrosis on LGE (HR: 2.131, 95% CI: 1.231-3.690, P = 0.007; HR: 3.161, 95% CI: 1.750-5.709, P < 0.001; and HR: 1.693, 95% CI: 1.084-2.644, P = 0.021, respectively). A composite clinical and CMR-based risk score provided a net reclassification improvement of 63.7% (P < 0.001) for MAACE occurrence when added to the model based on SOC evaluation. These findings were confirmed in the validation cohort. Conclusion: In a large multicentre, multivendor cohort registry reflecting daily clinical practice in NICM work-up, a composite clinical and CMR-based risk score provides incremental prognostic value beyond SOC evaluation, which may have impact on the indication of implantable cardioverter-defibrillator implantation.
Articolo in rivista - Articolo scientifico
Scientifica
Cardiac magnetic resonance; Heart failure; Implantable cardioverter-defibrillator; Non-ischaemic dilated cardiomyopathy; Primary prevention;
English
Guaricci, A., Masci, P., Muscogiuri, G., Guglielmo, M., Baggiano, A., Fusini, L., et al. (2021). CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Ischaemic dilated CardioMyopathy: an international Registry. EUROPACE, 23(7), 1072-1083 [10.1093/europace/euaa401].
Guaricci, A; Masci, P; Muscogiuri, G; Guglielmo, M; Baggiano, A; Fusini, L; Lorenzoni, V; Martini, C; Andreini, D; Pavon, A; Aquaro, G; Barison, A; Todiere, G; Rabbat, M; Tat, E; Raineri, C; Valentini, A; Varga-Szemes, A; Schoepf, U; De Cecco, C; Bogaert, J; Dobrovie, M; Symons, R; Focardi, M; Gismondi, A; Lozano-Torres, J; Rodriguez-Palomares, J; Lanzillo, C; Di Roma, M; Moro, C; Di Giovine, G; Margonato, D; De Lazzari, M; Perazzolo Marra, M; Nese, A; Casavecchia, G; Gravina, M; Marzo, F; Carigi, S; Pica, S; Lombardi, M; Censi, S; Squeri, A; Palumbo, A; Gaibazzi, N; Camastra, G; Sbarbati, S; Pedrotti, P; Masi, A; Carrabba, N; Pradella, S; Timpani, M; Cicala, G; Presicci, C; Puglisi, S; Sverzellati, N; Santobuono, V; Pepi, M; Schwitter, J; Pontone, G
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/377060
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