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Cardiac magnetic resonance for prophylactic implantable-cardioverter defibrillator therapy international study: prognostic value of cardiac magnetic resonance-derived right ventricular parameters substudy

2022; Oxford University Press; Volume: 24; Issue: 4 Linguagem: Inglês

10.1093/ehjci/jeac124

2047-2412

Subhi J. Al’Aref, Ahmed Altibi, Abdallah Malkawi, Munthir Mansour, Lohendran Baskaran, Ahmad Masri, Hind Rahmouni, Raffaele Abete, Daniele Andreini, Giovanni Donato Aquaro, Andrea Barison, Jan Bogaert, Giovanni Camastra, Samuela Carigi, Nazario Carrabba, Grazia Casavecchia, Stefano Censi, Gloria Cicala, Edoardo Conte, Carlo N. De Cecco, Manuel De Lazzari, Gabriella Di Giovine, Mauro Roma, Monica Dobrovie, Marta Focardi, Nicola Gaibazzi, Annalaura Gismondi, Matteo Gravina, Marco Guglielmo, Chiara Lanzillo, Massimo Lombardi, Valentina Lorenzoni, Jordi Lozano-Torres, Davide Margonato, Chiara Martini, Francesca Marzo, Pier Giorgio Masci, Ambra Masi, Riccardo Memeo, Claudio Moro, Saima Mushtaq, Alberto Nese, Alessandro Palumbo, Anna Giulia Pavon, Patrizia Pedrotti, Mauro Pepi, Martina Perazzolo Marra, Silvia Pica, Silvia Pradella, Cristina Presicci, Mark Rabbat, Claudia Raineri, José F. Rodríguez‐Palomares, Stefano Sbarbati, U. Joseph Schoepf, Angelo Squeri, Nicola Sverzellati, Rolf Symons, Emily Tat, Mauro Timpani, Giancarlo Todiere, Adele Valentini, Ákos Varga‐Szemes, Alessandra Volpe, Laura Fusini, Andrea Igoren Guaricci, Juerg Schwitter, Gianluca Pontone,

Cardiac Imaging and Diagnostics

Right ventricular systolic dysfunction (RVSD) is an important determinant of outcomes in heart failure (HF) cohorts. While the quantitative assessment of RV function is challenging using 2D-echocardiography, cardiac magnetic resonance (CMR) is the gold standard with its high spatial resolution and precise anatomical definition. We sought to investigate the prognostic value of CMR-derived RV systolic function in a large cohort of HF with reduced ejection fraction (HFrEF).Study cohort comprised of patients enrolled in the CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DefibrillAtor ThErapy registry who had HFrEF and had simultaneous baseline CMR and echocardiography (n = 2449). RVSD was defined as RV ejection fraction (RVEF) <45%. Kaplan-Meier curves and cox regression were used to investigate the association between RVSD and all-cause mortality (ACM). Mean age was 59.8 ± 14.0 years, 42.0% were female, and mean left ventricular ejection fraction (LVEF) was 34.0 ± 10.8. Median follow-up was 959 days (interquartile range: 560-1590). RVSD was present in 936 (38.2%) and was an independent predictor of ACM (adjusted hazard ratio = 1.44; 95% CI [1.09-1.91]; P = 0.01). On subgroup analyses, the prognostic value of RVSD was more pronounced in NYHA I/II than in NYHA III/IV, in LVEF <35% than in LVEF ≥35%, and in patients with renal dysfunction when compared to those with normal renal function.RV systolic dysfunction is an independent predictor of ACM in HFrEF, with a more pronounced prognostic value in select subgroups, likely reflecting the importance of RVSD in the early stages of HF progression.