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Is entropy evaluated by SPECT a predictor of life-threatening ventricular arrhythmia in ischemic cardiomyopathy?
- Source :
- Archives of Cardiovascular Diseases Supplements. 13:98
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background The risk assessment for ventricular arrhythmia in patients with ischemic cardiomyopathy is, at the present time, unspecific. Left ventricular (LV) entropy is a measure of myocardial heterogeneity derived from single photon emission computed tomography (SPECT). Purpose This study assesses the utility of LV entropy for predicting cardiovascular events in patients with ischemic cardiomyopathy. Methods Patients with ischemic cardiomyopathy referred for implantable cardioverter-defibrillator (ICD) implantation were included retrospectively. Their LV entropy was measured on SPECT. Patients were followed from implantable cardioverter-defibrillator placement to detect arrhythmic events (appropriate implantable cardioverter-defibrillator therapy and sustained ventricular arrhythmia), end-stage heart failure events (congestive heart failure, transplantation, or ventricular assist device placement), and cardiac death. Results Forty patients (mean age 68.1 ± 9.4 years, 75% men, LV ejection fraction 29.7 ± 4.6%) were followed for 22.8 ± 12.9 months. Of the forty patients, three (7.5%) experienced arrhythmic events, one died of advanced heart failure after receiving the appropriate shock, and three others (7.5%) experienced end-stage heart failure events. On univariate analysis, age (HR: 1.02 [0.99; 1.04]; P = 0.176); diabetes (HR: 0.30 [0.05; 1.68]; P = 0.17), CRT-D (HR: 0.06 [0.007; 0.53]; P = 0.01), NYHA class (HR: 7.6 [2.00; 29.5]; P = 0.003) and ischemia (HR: 1.07 [0.96; 1.18]; P = 0.19) were significant predictors of cardiac events. On multivariate analysis, CRT-D (HR: 0.06 [0.04; 0.89]; P = 0.04) remained a significant predictor of cardiac events. LV entropy was not a predictor of cardiac events. Conclusion In patients with ischemic cardiomyopathy, LV entropy measurement is not a predictor of life-threatening ventricular arrhythmia. However, CRT-D is a strong protector of ventricular arrhythmia in ischemic cardiomyopathy.
- Subjects :
- medicine.medical_specialty
Univariate analysis
Ejection fraction
Ischemic cardiomyopathy
medicine.diagnostic_test
business.industry
Ischemia
Single-photon emission computed tomography
medicine.disease
Transplantation
Internal medicine
Heart failure
cardiovascular system
medicine
Cardiology
Ventricular Assist Device Placement
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 18786480
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Archives of Cardiovascular Diseases Supplements
- Accession number :
- edsair.doi...........1c3de11c20597c5c65bcd92ef9c75c91