Abstract 12168: Risk Stratification for Ventricular Tachyarrhythmias in Patients With Cardiac Sarcoidosis by Cardiac Magnetic Resonance Imaging
Introduction: Recently, late gadolinium-enhancement (LGE) cardiac magnetic resonance (CMR) imaging, which has been used to uniquely characterize the myocardial fibrosis, is reported to have a prognostic value in cardiac sarcoidosis (CS)
Hypothesis: Not only fibrosis mass, but also its localization may help to identify the risk of ventricular tachyarrhythmias (VA) in patients with CS.
Methods: 70 consecutive CS patients underwent CMR (cine and LGE imaging). Left ventricular (LV) mass and fibrosis mass were calculated and the localization was analyzed using 17 segment model. VA was defined as sustained ventricular beats ≥ 3 or ventricular fibrillation. The patients underwent prospective follow-up through 2015 from CMR examinations.
Results: 33.3 % of the patients had a history of VA at the time of CMR examination. During a median follow-up of 15.5 months, 31.9 % had new-onset (11.6 %) or recurrent VA (20.3 %). Increased LV fibrosis mass (LVFM) was associated with the prevalence of VA (P < 0.001) and receiver operating characteristics curve analysis indicated good predictive performance of LVFM for the combined VA (history of VA and new-onset VA) (AUC = 0.788, best cut-off value; 8.28 g). In addition, when localization score (LS) was defined as the summation of LGE enhancement in LV basal anterior, basal anteroseptal, or RV out-flow tract (RVOT) lesion, it was associated with the combined VA (P < 0.001). Kaplan-Meier analysis showed that both LVFM and LS groupings were significantly associated with VA occurrence (Figure A). Furthermore, a combined analysis of LVFM and LS groups showed a better risk stratification for VA (Figure B).
Conclusions: Not only fibrosis mass, but also its localization of basal anterior, anteroseptal, or RVOT was associated with the history of VA as well as the prognosis for VA in patients with CS. CMR may be a useful tool for risk stratification for ventricular tachyarrhythmias by detecting myocardial fibrosis and localization in CS patients.
Author Disclosures: M. Yasuda: None. Y. Iwanaga: None. T. Kato: None. T. Izumi: None. Y. Inuzuka: None. T. Nakamura: None. T. Kawamura: None. S. Ikeguchi: None. M. Inoko: None. T. Kurita: None. S. Miyazaki: None.
- © 2015 by American Heart Association, Inc.