Shideh Anvari1, Mohammad Ali Akbarzadeh1,2, Fariba Bayat1, Mohammad Hasan Namazi1, Morteza Safi1. 1. Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Department of Cardiology, Modarres Hospital Research and Development Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND: Implantable cardioverter-defibrillator (ICD) is the most effective therapy currently available to prevent sudden cardiac death (SCD) in patients with left ventricular (LV) dysfunction. Although LV ejection fraction (LVEF) is an excellent marker of SCD in these patients, determining other predictors might help to identify patients who will be benefit more from device implantation. The purpose of this study was to determine whether abnormal LV sphericity index (SI) in transthoracic echocardiography is associated with appropriate ICD therapy in these patients. METHODS: A total of 140 patients with primary ICD implantation (mean age 62.59 ± 11.36 years; 98 [70%] male) were included. The patients were classified into "no ICD therapy" or "ICD therapy" group according to the information of their devices for a maximum of 2 previous years. In four-chamber view image of transthoracic echocardiography, SI was calculated by dividing the major-axis dimension to minor-axis dimension of LV in both groups. RESULTS: Compared with patients with no ICD therapy, patients in ICD therapy group had lower LVEF (31.36 ± 9.58 vs 23.24 ± 6.03, P = 0.0001) and lower SI (1.79 ± 0.29 vs 1.57 ± 0.32, P = 0.0001). In multivariant logistic regression analysis, the SI of ≤1.58 was associated with fourfold increase of appropriate ICD therapy, even after adjusting for LVEF (odds ratio, 4.08; 95% confidence interval, 1.71-9.75; P = 0.02). CONCLUSION: Simple echocardiographic sphericity dimension index as a marker of cardiac remodeling may be an important predictor of appropriate ICD therapy in patients with primary prevention ICDs and may provide additive risk stratification in patients with LV systolic dysfunction.
BACKGROUND: Implantable cardioverter-defibrillator (ICD) is the most effective therapy currently available to prevent sudden cardiac death (SCD) in patients with left ventricular (LV) dysfunction. Although LV ejection fraction (LVEF) is an excellent marker of SCD in these patients, determining other predictors might help to identify patients who will be benefit more from device implantation. The purpose of this study was to determine whether abnormal LV sphericity index (SI) in transthoracic echocardiography is associated with appropriate ICD therapy in these patients. METHODS: A total of 140 patients with primary ICD implantation (mean age 62.59 ± 11.36 years; 98 [70%] male) were included. The patients were classified into "no ICD therapy" or "ICD therapy" group according to the information of their devices for a maximum of 2 previous years. In four-chamber view image of transthoracic echocardiography, SI was calculated by dividing the major-axis dimension to minor-axis dimension of LV in both groups. RESULTS: Compared with patients with no ICD therapy, patients in ICD therapy group had lower LVEF (31.36 ± 9.58 vs 23.24 ± 6.03, P = 0.0001) and lower SI (1.79 ± 0.29 vs 1.57 ± 0.32, P = 0.0001). In multivariant logistic regression analysis, the SI of ≤1.58 was associated with fourfold increase of appropriate ICD therapy, even after adjusting for LVEF (odds ratio, 4.08; 95% confidence interval, 1.71-9.75; P = 0.02). CONCLUSION: Simple echocardiographic sphericity dimension index as a marker of cardiac remodeling may be an important predictor of appropriate ICD therapy in patients with primary prevention ICDs and may provide additive risk stratification in patients with LV systolic dysfunction.
Authors: Camila M Urzua Fresno; Luciano Folador; Tamar Shalmon; Faisal Mhd Dib Hamad; Sheldon M Singh; Gauri R Karur; Nigel S Tan; Iqwal Mangat; Anish Kirpalani; Binita Riya Chacko; Laura Jimenez-Juan; Andrew T Yan; Djeven P Deva Journal: J Cardiovasc Magn Reson Date: 2021-06-10 Impact factor: 5.364