Complexity of scar and ventricular arrhythmias in dilated cardiomyopathy of any etiology: Long‐term data from the SCARFEAR (Cardiovascular Magnetic Resonance Predictors of Appropriate Implantable Cardioverter‐Defibrillator Therapy Delivery) Registry

摘要

Background Late gadolinium enhancement (LGE) assessed with cardiovascular magnetic resonance (CMR) correlates with ventricular arrhythmias and survival in patients with structural heart disease. Whether some LGE characteristics may specifically improve prediction of arrhythmic outcomes is unknown. Hypothesis We sought to evaluate scar characteristics assessed with CMR to predict implantable cardioverter‐defibrillator (ICD) interventions in dilated cardiomyopathy of different etiology. Methods 96 consecutive patients evaluated with CMR received an ICD. Biventricular volumes, ejection fraction, and myocardial LGE were evaluated. LGE was defined as “complex” (Cx‐LGE) in presence of ≥1 of the following: ischemic pattern, involving ≥2 different coronary territories; epicardial pattern; global endocardial pattern; and presence of ≥2 different patterns. The primary endpoint was occurrence of any appropriate ICD intervention. A composite secondary endpoint of cardiovascular death, cardiac transplantation, or ventricular assist device implantation was also considered. Results During a median follow‐up of 75 months, 30 and 25 patients reached the primary and secondary endpoints, respectively. Cx‐LGE was correlated with a worse primary endpoint survival (log‐rank P Conclusions Cx‐LGE identified at CMR imaging seems promising as an independent and specific prognostic factor of ventricular arrhythmias requiring ICD therapy in dilated cardiomyopathy of different etiologies.