Prognostic Role of Myocardial Edema as Evidenced by Early Cardiac Magnetic Resonance in Survivors of Out‐of‐Hospital Cardiac Arrest: A Multicenter Study

Background Sudden cardiac arrest (SCA) may be caused by an acute and reversible myocardial injury, a chronic and irreversible myocardial damage, or a primary ventricular arrhythmia. Cardiac magnetic resonance imaging may identify myocardial edema (ME), which denotes acute and reversible myocardial d...

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Autores principales:	Alessandro Zorzi, Giulia Mattesi, Enrico Baldi, Mauro Toniolo, Federico Guerra, Filippo Maria Cauti, Alberto Cipriani, Manuel De Lazzari, Daniele Muser, Giulia Stronati, Lina Marcantoni, Massimiliano Manfrin, Leonardo Calò, Chiara Lanzillo, Martina Perazzolo Marra, Simone Savastano, Domenico Corrado
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	cardiac magnetic resonance implantable cardioverter‐defibrillator out‐of‐hospital cardiac arrest prognosis ventricular arrhythmia Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/47f62022572643c79cc1d368696e1443
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spelling	oai:doaj.org-article:47f62022572643c79cc1d368696e14432021-11-16T10:22:43ZPrognostic Role of Myocardial Edema as Evidenced by Early Cardiac Magnetic Resonance in Survivors of Out‐of‐Hospital Cardiac Arrest: A Multicenter Study10.1161/JAHA.121.0218612047-9980https://doaj.org/article/47f62022572643c79cc1d368696e14432021-11-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.021861https://doaj.org/toc/2047-9980Background Sudden cardiac arrest (SCA) may be caused by an acute and reversible myocardial injury, a chronic and irreversible myocardial damage, or a primary ventricular arrhythmia. Cardiac magnetic resonance imaging may identify myocardial edema (ME), which denotes acute and reversible myocardial damage. We evaluated the arrhythmic outcome of SCA survivors during follow‐up and tested the prognostic role of ME. Methods and Results We included a consecutive series of 101 (71% men, median age 47 years) SCA survivors from 9 collaborative centers who underwent early (<1 month) cardiac magnetic resonance imaging and received an implantable cardioverter‐defibrillator (ICD). On T2‐weighted sequences, ME was found in 18 of 101 (18%) patients. According to cardiac magnetic resonance imaging findings, the arrhythmic SCA was ascribed to acute myocardial injury (either ischemic [n=10] or inflammatory [n=8]), to chronic structural heart diseases (ischemic heart disease [n=11], cardiomyopathy [n=20], or other [n=23]), or to primarily arrhythmic syndrome (n=29). During a follow‐up of 47 months (28 to 67 months), 24 of 101 (24%) patients received an appropriate ICD intervention. ME was associated with a significantly higher survival free from both any ICD interventions (log‐rank=0.04) and ICD shocks (log‐rank=0.03) and remained an independent predictor of better arrhythmic outcome after adjustment for left ventricular ejection fraction and late gadolinium enhancement. The risk of appropriate ICD intervention was unrelated to the type of underlying heart disease. Conclusions ME on early cardiac magnetic resonance imaging, which denotes an acute and transient arrhythmogenic substrate, predicted a favorable long‐term arrhythmic outcome of SCA survivors. These findings may have a substantial impact on future guidelines on the management of SCA survivors.Alessandro ZorziGiulia MattesiEnrico BaldiMauro TonioloFederico GuerraFilippo Maria CautiAlberto CiprianiManuel De LazzariDaniele MuserGiulia StronatiLina MarcantoniMassimiliano ManfrinLeonardo CalòChiara LanzilloMartina Perazzolo MarraSimone SavastanoDomenico CorradoWileyarticlecardiac magnetic resonanceimplantable cardioverter‐defibrillatorout‐of‐hospital cardiac arrestprognosisventricular arrhythmiaDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 22 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cardiac magnetic resonance implantable cardioverter‐defibrillator out‐of‐hospital cardiac arrest prognosis ventricular arrhythmia Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	cardiac magnetic resonance implantable cardioverter‐defibrillator out‐of‐hospital cardiac arrest prognosis ventricular arrhythmia Diseases of the circulatory (Cardiovascular) system RC666-701 Alessandro Zorzi Giulia Mattesi Enrico Baldi Mauro Toniolo Federico Guerra Filippo Maria Cauti Alberto Cipriani Manuel De Lazzari Daniele Muser Giulia Stronati Lina Marcantoni Massimiliano Manfrin Leonardo Calò Chiara Lanzillo Martina Perazzolo Marra Simone Savastano Domenico Corrado Prognostic Role of Myocardial Edema as Evidenced by Early Cardiac Magnetic Resonance in Survivors of Out‐of‐Hospital Cardiac Arrest: A Multicenter Study
description	Background Sudden cardiac arrest (SCA) may be caused by an acute and reversible myocardial injury, a chronic and irreversible myocardial damage, or a primary ventricular arrhythmia. Cardiac magnetic resonance imaging may identify myocardial edema (ME), which denotes acute and reversible myocardial damage. We evaluated the arrhythmic outcome of SCA survivors during follow‐up and tested the prognostic role of ME. Methods and Results We included a consecutive series of 101 (71% men, median age 47 years) SCA survivors from 9 collaborative centers who underwent early (<1 month) cardiac magnetic resonance imaging and received an implantable cardioverter‐defibrillator (ICD). On T2‐weighted sequences, ME was found in 18 of 101 (18%) patients. According to cardiac magnetic resonance imaging findings, the arrhythmic SCA was ascribed to acute myocardial injury (either ischemic [n=10] or inflammatory [n=8]), to chronic structural heart diseases (ischemic heart disease [n=11], cardiomyopathy [n=20], or other [n=23]), or to primarily arrhythmic syndrome (n=29). During a follow‐up of 47 months (28 to 67 months), 24 of 101 (24%) patients received an appropriate ICD intervention. ME was associated with a significantly higher survival free from both any ICD interventions (log‐rank=0.04) and ICD shocks (log‐rank=0.03) and remained an independent predictor of better arrhythmic outcome after adjustment for left ventricular ejection fraction and late gadolinium enhancement. The risk of appropriate ICD intervention was unrelated to the type of underlying heart disease. Conclusions ME on early cardiac magnetic resonance imaging, which denotes an acute and transient arrhythmogenic substrate, predicted a favorable long‐term arrhythmic outcome of SCA survivors. These findings may have a substantial impact on future guidelines on the management of SCA survivors.
format	article
author	Alessandro Zorzi Giulia Mattesi Enrico Baldi Mauro Toniolo Federico Guerra Filippo Maria Cauti Alberto Cipriani Manuel De Lazzari Daniele Muser Giulia Stronati Lina Marcantoni Massimiliano Manfrin Leonardo Calò Chiara Lanzillo Martina Perazzolo Marra Simone Savastano Domenico Corrado
author_facet	Alessandro Zorzi Giulia Mattesi Enrico Baldi Mauro Toniolo Federico Guerra Filippo Maria Cauti Alberto Cipriani Manuel De Lazzari Daniele Muser Giulia Stronati Lina Marcantoni Massimiliano Manfrin Leonardo Calò Chiara Lanzillo Martina Perazzolo Marra Simone Savastano Domenico Corrado
author_sort	Alessandro Zorzi
title	Prognostic Role of Myocardial Edema as Evidenced by Early Cardiac Magnetic Resonance in Survivors of Out‐of‐Hospital Cardiac Arrest: A Multicenter Study
title_short	Prognostic Role of Myocardial Edema as Evidenced by Early Cardiac Magnetic Resonance in Survivors of Out‐of‐Hospital Cardiac Arrest: A Multicenter Study
title_full	Prognostic Role of Myocardial Edema as Evidenced by Early Cardiac Magnetic Resonance in Survivors of Out‐of‐Hospital Cardiac Arrest: A Multicenter Study
title_fullStr	Prognostic Role of Myocardial Edema as Evidenced by Early Cardiac Magnetic Resonance in Survivors of Out‐of‐Hospital Cardiac Arrest: A Multicenter Study
title_full_unstemmed	Prognostic Role of Myocardial Edema as Evidenced by Early Cardiac Magnetic Resonance in Survivors of Out‐of‐Hospital Cardiac Arrest: A Multicenter Study
title_sort	prognostic role of myocardial edema as evidenced by early cardiac magnetic resonance in survivors of out‐of‐hospital cardiac arrest: a multicenter study
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/47f62022572643c79cc1d368696e1443
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Prognostic Role of Myocardial Edema as Evidenced by Early Cardiac Magnetic Resonance in Survivors of Out‐of‐Hospital Cardiac Arrest: A Multicenter Study

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