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Arrhythmic predictors in non-dilated left ventricular cardiomyopathy
Session:
Sessão de Posters 48 - Risco arrítmico, tomada de decisão e desfechos nas miocardiopatias
Speaker:
David Vicente Marques
Congress:
CPC 2026
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.6 Myocardial Disease – Clinical
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
David Vicente Marques; Leonor Magalhães; Isabel Cardoso; José Viegas; Pedro Brás; Inês Grácio de Almeida; Vera Ferreira; Pedro Silva Cunha; Guilherme Portugal; Mário Oliveira; Sílvia Aguiar Rosa; Rui Cruz Ferreira
Abstract
<p style="text-align:justify"><strong>Abstract</strong><br /> <br /> Non-dilated left ventricular cardiomyopathy (NDLVC) is characterized<br /> by the presence of non-ischemic left ventricle (LV) scarring or fatty<br /> replacement, regardless of the presence of regional wall motion<br /> abnormalities, or isolated global LV hypokinesia without scarring or<br /> dilation. Arrhythmic events play an important prognostic role in a<br /> subpopulation of patients with NDLVC, so an accurate identification of<br /> individuals with increased arrhythmic risk is of major importance. In<br /> this study we aim to analyze a cohort of patients with NDLVC and look<br /> for potential predictors of major arrhythmic events (MAE).<br /> <br /> <strong>Methods</strong><br /> <br /> The study enrolled 48 patients (P) (64.6% male, mean age of 51 ±15.1<br /> years) with NDLVC followed up at a cardiomyopathy outpatient clinic of<br /> a tertiary center, for a median follow-up time of 846 days.<br /> Retrospective analysis of clinical, electrocardiographic and imaging<br /> data were performed. The primary endpoint assessed the occurrence of<br /> MAE (ventricular fibrillation, sustained ventricular tachycardia and<br /> implantable cardioverter-defibrillator therapy). Statistical analysis<br /> was performed using chi-square and Mann-whitney tests, as appropriate.<br /> <br /> <strong>Results</strong><br /> <br /> Patient characteristics are shown in table 1.<br /> <br /> There were 6 P (12.5%) who suffered MAE within the follow-up time. In<br /> our analysis, the extension of fibrosis (number of segments affected)<br /> on cardiac magnetic resonance (CMR) showed statistical significance in<br /> predicting MAE (p=0.004), with ≥ 3.5 segments affected showing a<br /> sensibility of 100% and specificity of 80,5%. Native T1 mapping<br /> analysis showed that P with ≥1163 ms had a higher risk of MAE<br /> (p=0.017). ECG analysis showed that T wave inversion (TWI) ≥ 2 leads<br /> was positive in predicting MAE (p=0.016). Of the total, 42 P were<br /> submitted to genetic testing, being 21 P (50%) positive for high-risk<br /> genes (Filamin C, Lamina, Desmoplakin). In our group, high risk genes did not<br /> correlate with MAE.<br /> <br /> The recently developed NDLVC-5Y risk score did not show a significant<br /> association with arrhythmia occurrence (p=0.369).<br /> <br /> <strong>Conclusions</strong><br /> <br /> In a single-center cohort of patients with NDLVC, the extension of<br /> fibrosis on CMR markers and ECG abnormalities were associated with the<br /> occurrence of MAE. The number of segments affected with fibrosis,<br /> elevated values of native T1 mapping and the presence of T-wave<br /> inversion ≥ 2 leads emerged as prognostic markers. NDLVC-5Y risk score<br /> did not predict MAE in our cohort, a likely explanation is that all<br /> patients with risk score >20% had a short follow-up (<3 years). These<br /> findings highlight the potential additional value of CMR and<br /> electrocardiographic parameters for an integrated arrhythmic risk<br /> stratification in NDLVC.</p>
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