Risk stratification of patients with Brugada syndrome: the impact of myocardial strain analysis using cardiac magnetic resonance feature trackingBrief summary

Objective: This study evaluated the prognostic significance of cardiac magnetic resonance myocardial feature tracking (CMR-FT) in patients with Brugada syndrome (BrS) to detect subclinical alterations and predict major adverse events (MAE). Methods: CMR was performed in 106 patients with BrS and 25...

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Autores principales:	Anna Hohneck, Daniel Overhoff, Marlon Rutsch, Boris Rudic, Erol Tülümen, Christian Wolpert, Svetlana Hetjens, Ibrahim Akin, Martin Borggrefe, Theano Papavassiliu
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Brugada syndrome cardiac magnetic resonance feature tracking Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/a45a6012d34d46beb416a7149b52da2e
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spelling	oai:doaj.org-article:a45a6012d34d46beb416a7149b52da2e2021-11-14T04:31:12ZRisk stratification of patients with Brugada syndrome: the impact of myocardial strain analysis using cardiac magnetic resonance feature trackingBrief summary1109-966610.1016/j.hjc.2021.05.003https://doaj.org/article/a45a6012d34d46beb416a7149b52da2e2021-09-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1109966621001093https://doaj.org/toc/1109-9666Objective: This study evaluated the prognostic significance of cardiac magnetic resonance myocardial feature tracking (CMR-FT) in patients with Brugada syndrome (BrS) to detect subclinical alterations and predict major adverse events (MAE). Methods: CMR was performed in 106 patients with BrS and 25 healthy controls. Biventricular global strain analysis was assessed using CMR-FT. Patients were followed over a median of 11.6 [8.8 ± 13.8] years. Results: The study cohort was subdivided according to the presence of a spontaneous type 1 ECG (sECG) into sBrS (BrS with sECG, n = 34 (32.1%)) and diBrS (BrS with drug-induced type 1 ECG, n = 72 (67.9%)). CMR-FT revealed morphological differences between sBrS and diBrS patients with regard to right ventricular (RV) strain (circumferential (%) (sBrS −7.9 ± 2.9 vs diBrS - 9.5 ± 3.1, p = 0.02) and radial (%) (sBrS 12.0 ± 4.3 vs diBrS 15.4 ± 5.4, p = 0.004)). During follow-up, MAE occurred in 11 patients (10.4%). Multivariable analysis was performed to identify independent predictors for the occurrence of events during follow-up. The strongest predictive value was found for RV circumferential strain (OR 3.2 (95% CI 1.4 - 6.9), p = 0.02) and RVOT/BSA (OR 3.1 (95% CI 1.0 - 7.0), p = 0.03). Conclusions: Myocardial strain analysis detected early subclinical alterations, prior to apparent changes in myocardial function, in patients with BrS. While usual functional parameters were within the normal range, CMR-FT revealed pathological results in patients with an sECG.Moreover, RV circumferential strain and RVOT size provided additional prognostic information on the occurrence of MAE during follow-up, which reflects electrical vulnerability.Anna HohneckDaniel OverhoffMarlon RutschBoris RudicErol TülümenChristian WolpertSvetlana HetjensIbrahim AkinMartin BorggrefeTheano PapavassiliuElsevierarticleBrugada syndromecardiac magnetic resonancefeature trackingDiseases of the circulatory (Cardiovascular) systemRC666-701ENHellenic Journal of Cardiology, Vol 62, Iss 5, Pp 329-338 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Brugada syndrome cardiac magnetic resonance feature tracking Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Brugada syndrome cardiac magnetic resonance feature tracking Diseases of the circulatory (Cardiovascular) system RC666-701 Anna Hohneck Daniel Overhoff Marlon Rutsch Boris Rudic Erol Tülümen Christian Wolpert Svetlana Hetjens Ibrahim Akin Martin Borggrefe Theano Papavassiliu Risk stratification of patients with Brugada syndrome: the impact of myocardial strain analysis using cardiac magnetic resonance feature trackingBrief summary
description	Objective: This study evaluated the prognostic significance of cardiac magnetic resonance myocardial feature tracking (CMR-FT) in patients with Brugada syndrome (BrS) to detect subclinical alterations and predict major adverse events (MAE). Methods: CMR was performed in 106 patients with BrS and 25 healthy controls. Biventricular global strain analysis was assessed using CMR-FT. Patients were followed over a median of 11.6 [8.8 ± 13.8] years. Results: The study cohort was subdivided according to the presence of a spontaneous type 1 ECG (sECG) into sBrS (BrS with sECG, n = 34 (32.1%)) and diBrS (BrS with drug-induced type 1 ECG, n = 72 (67.9%)). CMR-FT revealed morphological differences between sBrS and diBrS patients with regard to right ventricular (RV) strain (circumferential (%) (sBrS −7.9 ± 2.9 vs diBrS - 9.5 ± 3.1, p = 0.02) and radial (%) (sBrS 12.0 ± 4.3 vs diBrS 15.4 ± 5.4, p = 0.004)). During follow-up, MAE occurred in 11 patients (10.4%). Multivariable analysis was performed to identify independent predictors for the occurrence of events during follow-up. The strongest predictive value was found for RV circumferential strain (OR 3.2 (95% CI 1.4 - 6.9), p = 0.02) and RVOT/BSA (OR 3.1 (95% CI 1.0 - 7.0), p = 0.03). Conclusions: Myocardial strain analysis detected early subclinical alterations, prior to apparent changes in myocardial function, in patients with BrS. While usual functional parameters were within the normal range, CMR-FT revealed pathological results in patients with an sECG.Moreover, RV circumferential strain and RVOT size provided additional prognostic information on the occurrence of MAE during follow-up, which reflects electrical vulnerability.
format	article
author	Anna Hohneck Daniel Overhoff Marlon Rutsch Boris Rudic Erol Tülümen Christian Wolpert Svetlana Hetjens Ibrahim Akin Martin Borggrefe Theano Papavassiliu
author_facet	Anna Hohneck Daniel Overhoff Marlon Rutsch Boris Rudic Erol Tülümen Christian Wolpert Svetlana Hetjens Ibrahim Akin Martin Borggrefe Theano Papavassiliu
author_sort	Anna Hohneck
title	Risk stratification of patients with Brugada syndrome: the impact of myocardial strain analysis using cardiac magnetic resonance feature trackingBrief summary
title_short	Risk stratification of patients with Brugada syndrome: the impact of myocardial strain analysis using cardiac magnetic resonance feature trackingBrief summary
title_full	Risk stratification of patients with Brugada syndrome: the impact of myocardial strain analysis using cardiac magnetic resonance feature trackingBrief summary
title_fullStr	Risk stratification of patients with Brugada syndrome: the impact of myocardial strain analysis using cardiac magnetic resonance feature trackingBrief summary
title_full_unstemmed	Risk stratification of patients with Brugada syndrome: the impact of myocardial strain analysis using cardiac magnetic resonance feature trackingBrief summary
title_sort	risk stratification of patients with brugada syndrome: the impact of myocardial strain analysis using cardiac magnetic resonance feature trackingbrief summary
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/a45a6012d34d46beb416a7149b52da2e
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Risk stratification of patients with Brugada syndrome: the impact of myocardial strain analysis using cardiac magnetic resonance feature trackingBrief summary

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