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Prognostic value of cardiovascular magnetic resonance imaging for life-threatening arrhythmia detected by implantable cardioverter-defibrillator in Japanese patients with hypertrophic cardiomyopathy

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Abstract

Implantable cardioverter-defibrillator (ICD) is effective to prevent sudden death in HCM patients. We reviewed ICD records to analyze the relation between life-threatening arrhythmia and late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) in Japanese hypertrophic cardiomyopathy (HCM) patients. In 102 consecutive patients (median age 63 years, 63 males) implanted with an ICD after CMR with gadolinium enhancement (median follow-up 2.8 years), the outcome of life-threatening arrhythmic events (appropriate ICD interventions for ventricular tachycardia or ventricular fibrillation) was examined. Appropriate interventions rate were 10.3% per year for secondary prevention and 7.4% per year for primary prevention. The annualized ICD-related complication rate was 3.7%. 43/91 patients (47%) implanted ICD for primary prevention had maximum wall thickness ≥20 mm plus LGE in ≥4 of 17 left ventricular segments (cut-off value obtained from ROC curve); the appropriate ICD intervention rate was significantly higher in this group than in other patients group (annualized event rate, 11.1 vs. 4.6%; log-rank P = 0.038). A combination of myocardial hypertrophy and LGE is a useful outcome predictive factor for life-threatening ventricular arrhythmia in Japanese HCM patients.

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Acknowledgements

This study was supported by the Sakakibara Clinical Research Grant for Promotion of Science, 2016. We thank Mr. Naokazu Mizuno and Mr. Jun Matsuda of the staff at Sakakibara Heart Institute for technical assistance.

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Authors and Affiliations

  1. Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo, 183-0003, Japan

    Yasuki Hen, Mayuko Tsugu-Yagawa, Nobuo Iguchi, Yuko Utanohara, Ayako Takara, Kunihiko Teraoka, Kanki Inoue, Itaru Takamisawa, Morimasa Takayama & Tsutomu Yoshikawa

  2. Department of Radiology, Sakakibara Heart Institute, Fuchu, Japan

    Kaori Takada

  3. Department of Radiology, Tokyo Women’s Medical University Medical Center East, Tokyo, Japan

    Haruhiko Machida

Authors
  1. Yasuki Hen
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  2. Mayuko Tsugu-Yagawa
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  3. Nobuo Iguchi
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  4. Yuko Utanohara
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  12. Tsutomu Yoshikawa
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Correspondence to Yasuki Hen.

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Hen, Y., Tsugu-Yagawa, M., Iguchi, N. et al. Prognostic value of cardiovascular magnetic resonance imaging for life-threatening arrhythmia detected by implantable cardioverter-defibrillator in Japanese patients with hypertrophic cardiomyopathy. Heart Vessels 33, 49–57 (2018). https://doi.org/10.1007/s00380-017-1030-3

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