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Imaging modality for left ventricular ejection fraction estimation and effect of implantable cardioverter-defibrillator on mortality in patients with heart failure.
- Source :
- Heart Rhythm; Jun2023, Vol. 20 Issue 6, p886-890, 5p
- Publication Year :
- 2023
-
Abstract
- Implantable cardioverter-defibrillators (ICDs) improve outcomes in patients with heart failure (HF) with left ventricular ejection fraction (LVEF) ≤35%. Less is known about whether outcomes varied between the 2 noninvasive imaging modalities used to estimate LVEF—2-dimensional echocardiography (2DE) and multigated acquisition radionuclide ventriculography (MUGA)—which use different principles (geometric vs count-based, respectively). The purpose of this study was to examine whether the effect of ICD on mortality in patients with HF and LVEF ≤35% varied on the basis of LVEF measured by 2DE or MUGA. Of the 2521 patients with HF with LVEF ≤35% in the Sudden Cardiac Death in Heart Failure Trial, 1676 (66%) were randomized to either placebo or ICD, of whom 1386 (83%) had LVEF measured by 2DE (n = 971) or MUGA (n = 415). Hazard ratios (HRs) and 97.5% confidence intervals (CIs) for mortality associated with ICD were estimated overall, checking for interaction, and within the 2 imaging subgroups. Of the 1386 patients in the present analysis, all-cause mortality occurred in 23.1% (160 of 692) and 29.7% (206 of 694) of patients randomized to ICD or placebo, respectively (HR 0.77; 97.5% CI 0.61–0.97), which is consistent with that in 1676 patients in the original report. HRs (97.5% CIs) for all-cause mortality in the 2DE and MUGA subgroups were 0.79 (0.60–1.04) and 0.72 (0.46–1.11), respectively (P =.693 for interaction). Similar associations were observed for cardiac and arrhythmic mortalities. We found no evidence that in patients with HF and LVEF ≤35%, the effect of ICD on mortality varied by the noninvasive imaging method used to measure LVEF. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 15475271
- Volume :
- 20
- Issue :
- 6
- Database :
- Supplemental Index
- Journal :
- Heart Rhythm
- Publication Type :
- Academic Journal
- Accession number :
- 163696832
- Full Text :
- https://doi.org/10.1016/j.hrthm.2023.03.010