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Ventricular Arrhythmias and Sudden Death in Nonischemic Dilated Cardiomyopathy: Matter of Sex or Scar?
- Source :
-
Journal of cardiac failure [J Card Fail] 2022 Aug; Vol. 28 (8), pp. 1278-1286. Date of Electronic Publication: 2022 Feb 15. - Publication Year :
- 2022
-
Abstract
- Background: To evaluate the association between sex and ventricular arrhythmias (VA) or sudden death (SD) in nonischemic dilated cardiomyopathy, including analysis of potential confounders.<br />Methods and Results: Retrospective cohort study of consecutive patients with DCM referred for cardiac magnetic resonance at 2 tertiary hospitals. The primary combined end point encompassed sustained VA, appropriate implantable cardioverter defibrillator therapies, resuscitated cardiac arrest, and SD. We included 1165 patients with median follow-up of 36 months (interquartile range 20-58 months). The majority of patients (66%) were males. Males and females had similar left ventricular ejection fraction, but the prevalence of late gadolinium enhancement (LGE) at cardiac magnetic resonance was significantly higher among males (48% vs 30%, P < .001). Males had higher cumulative incidence of the primary end point (8% vs 4%, P = .02), and male sex was a significant predictor of the primary end point at univariate analysis (hazard ratio 1.93, P = .02). However, LGE had a major confounding effect in the association between sex and the primary outcome: the hazard ratio of male sex adjusted for LGE was 1.29 (P = .37). LGE+ females had significantly higher cumulative incidence of the primary end point than LGE- males (13% vs 1.8%, P < .001).<br />Conclusions: In patients with DCM, the prevalence of LGE is significantly higher among males, implying a major confounding effect in the association between male sex and VA or SD. LGE+ females have significantly higher risk than LGE- males. These data do not support the inclusion of sex into risk stratification algorithms for VA or SD in DCM.<br />Competing Interests: Conflict of interest None declared.<br /> (Copyright © 2022 Elsevier Inc. All rights reserved.)
- Subjects :
- Arrhythmias, Cardiac
Cicatrix complications
Contrast Media
Death, Sudden, Cardiac epidemiology
Death, Sudden, Cardiac etiology
Female
Gadolinium
Humans
Magnetic Resonance Imaging, Cine methods
Male
Predictive Value of Tests
Retrospective Studies
Stroke Volume
Ventricular Function, Left
Cardiomyopathy, Dilated complications
Cardiomyopathy, Dilated diagnosis
Heart Failure complications
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8414
- Volume :
- 28
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of cardiac failure
- Publication Type :
- Academic Journal
- Accession number :
- 35176484
- Full Text :
- https://doi.org/10.1016/j.cardfail.2022.01.019