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Sudden Cardiac Death Prediction in Arrhythmogenic Right Ventricular Cardiomyopathy: A Multinational Collaboration.
Cadrin-Tourigny, Julia; Bosman, Laurens P; Wang, Weijia; Tadros, Rafik; Bhonsale, Aditya; Bourfiss, Mimount; Lie, Øyvind H; Saguner, Ardan M; Svensson, Anneli; Andorin, Antoine; Tichnell, Crystal; Murray, Brittney; Zeppenfeld, Katja; van den Berg, Maarten P; Asselbergs, Folkert W; Wilde, Arthur A M; Krahn, Andrew D; Talajic, Mario; Rivard, Lena; Chelko, Stephen; Zimmerman, Stefan L; Kamel, Ihab R; Crosson, Jane E; Judge, Daniel P; Yap, Sing-Chien; Van der Heijden, Jeroen F; Tandri, Harikrishna; Jongbloed, Jan D H; van Tintelen, J Peter; Platonov, Pyotr G; Duru, Firat; Haugaa, Kristina H; Khairy, Paul; Hauer, Richard N W; Calkins, Hugh; Te Riele, Anneline S J M; James, Cynthia A.
Afiliación
  • Cadrin-Tourigny J; 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.
  • Bosman LP; Cardiovascular Genetics Center, Montreal Heart Institute, Université de Montréal, Canada (J.C.-T., R.T., A.A., M.T., L.R., P.K.).
  • Wang W; Netherlands Heart Institute (L.P.B., F.W.A., J.P.v.T., R.N.W.H., A.S.J.M.t.R.).
  • Tadros R; 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.
  • Bhonsale A; 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.
  • Bourfiss M; Cardiovascular Genetics Center, Montreal Heart Institute, Université de Montréal, Canada (J.C.-T., R.T., A.A., M.T., L.R., P.K.).
  • Lie ØH; 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.
  • Saguner AM; 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.
  • Svensson A; Department of Cardiology and Research group for Cardiogenetics and Sudden Cardiac Death, Oslo University Hospital, Rikshospitalet, Norway (Ø.H.L., K.H.H.).
  • Andorin A; Department of Cardiology, University Heart Center Zurich, Switzerland (A.M.S., F.D.).
  • Tichnell C; Department of Cardiology and Department of Medical & Health Sciences, Linköping University, Swede (A.S.).
  • Murray B; Cardiovascular Genetics Center, Montreal Heart Institute, Université de Montréal, Canada (J.C.-T., R.T., A.A., M.T., L.R., P.K.).
  • Zeppenfeld K; 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.
  • van den Berg MP; 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.
  • Asselbergs FW; Department of Cardiology, Leiden University Medical Center (K.Z.).
  • Wilde AAM; Department of Cardiology (M.P.v.d.B.), University Medical Center Groningen, University of Groningen, the Netherlands.
  • Krahn AD; Netherlands Heart Institute (L.P.B., F.W.A., J.P.v.T., R.N.W.H., A.S.J.M.t.R.).
  • Talajic M; 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.
  • Rivard L; Institute of Cardiovascular Science & Institute of Health Informatics, Faculty of Population Health Sciences, University College London, United Kingdom (F.W.A.).
  • Chelko S; Amsterdam UMC, University of Amsterdam, Heart Center (A.A.M.W.).
  • Zimmerman SL; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, the Netherlands (A.A.M.W.).
  • Kamel IR; Division of Cardiology, University of British Columbia, Vancouver, Canada (A.D.K.).
  • Crosson JE; Cardiovascular Genetics Center, Montreal Heart Institute, Université de Montréal, Canada (J.C.-T., R.T., A.A., M.T., L.R., P.K.).
  • Judge DP; Cardiovascular Genetics Center, Montreal Heart Institute, Université de Montréal, Canada (J.C.-T., R.T., A.A., M.T., L.R., P.K.).
  • Yap SC; 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.
  • Van der Heijden JF; Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee (S.C.).
  • Tandri H; The Russell H. Morgan Department of Radiology and Radiological Science (S.L.Z., I.R.K.), Johns Hopkins Hospital, Baltimore, MD.
  • Jongbloed JDH; The Russell H. Morgan Department of Radiology and Radiological Science (S.L.Z., I.R.K.), Johns Hopkins Hospital, Baltimore, MD.
  • van Tintelen JP; 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.
  • Platonov PG; 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.
  • Duru F; Department of Cardiology, Erasmus Medical Center, Rotterdam (S.-C.Y.).
  • Haugaa KH; 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.
  • Khairy P; 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.
  • Hauer RNW; Department of Genetics (J.D.H.J.), University Medical Center Groningen, University of Groningen, the Netherlands.
  • Calkins H; Netherlands Heart Institute (L.P.B., F.W.A., J.P.v.T., R.N.W.H., A.S.J.M.t.R.).
  • Te Riele ASJM; Department of Genetics (J.P.v.T.), University Medical Center Utrecht, Utrecht University, the Netherlands.
  • James CA; Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, the Netherlands (J.P.v.T.).
Circ Arrhythm Electrophysiol ; 14(1): e008509, 2021 01.
Article en En | MEDLINE | ID: mdl-33296238
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.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Función Ventricular Derecha / Muerte Súbita Cardíaca / Displasia Ventricular Derecha Arritmogénica Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Circ Arrhythm Electrophysiol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Moldova
Texto completo
Imprimir
XML
PubMed Links
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Función Ventricular Derecha / Muerte Súbita Cardíaca / Displasia Ventricular Derecha Arritmogénica Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Circ Arrhythm Electrophysiol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Moldova