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Image-Based Left-Ventricular Shape Analysis for Sudden Cardiac Death Risk Stratification.
MedLine Citation:
PMID:  24854217     Owner:  NLM     Status:  Publisher    
BACKGROUND: Low left-ventricular ejection fraction (LVEF), the main criterion used in current clinical practice to stratify sudden cardiac death (SCD) risk, has very low sensitivity and specificity.
OBJECTIVE: To uncover indices of LV shape that differ between patients with a high risk of SCD and those with a low risk.
METHODS: Utilizing clinical cardiac magnetic resonance (CMR) imaging and computational anatomy tools, a novel computational framework to compare three-dimensional (3D) LV endocardial surface curvedness, wall thickness (WT), and relative wall thickness (RWT) between patient groups was implemented. The framework was applied to CMR data of 61 patients with ischemic cardiomyopathy who were selected for prophylactic implantable cardioverter defibrillator treatment based on reduced LVEF. The patients were classified by outcome: group 0 had no events; group 1, arrhythmic events, and group 2, heart failure (HF). Segmental differences in LV shape were assessed.
RESULTS: Global LV volumes and mass were similar amongst groups. Compared to patients with no events, patients in groups 1 and 2 had lower mean shape metrics in all coronary artery regions, with statistical significance in 9 comparisons, reflecting wall thinning and stretching/flattening.
CONCLUSIONS: Among patients with ischemic cardiomyopathy and low LVEF, there exist quantifiable differences in 3D endocardial surface curvedness, LVWT, and LVRWT between those with no clinical events, and those with arrhythmic or HF outcomes, reflecting adverse LV remodeling. This retrospective study is a proof-of-concept to demonstrate that regional LV remodeling indices have the potential to improve personalized risk assessment for SCD.
Fijoy Vadakkumpadan; Natalia Trayanova; Katherine C Wu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-19
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
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