PhD Scientific Days 2023

Clinical Medicine - Posters A

Predictive Value of Scar Burden Assessed by Cardiac MRI on Sudden Cardiac Death in Cardiac Resynchronization Therapy Patients: a Systematic Review and Meta-Analysis

Előadó neve

Dr. Masszi, Richárd

Neptun code

e6skpl

Előadó munkahelye

Semmelweis University Heart and Vascular Center

Előadó telefonszáma

06304997593

Előadó e-mail címe

masszi.richard@gmail.com

Az előadás címe

Predictive Value of Scar Burden Assessed by Cardiac MRI on Sudden Cardiac Death in Cardiac Resynchronization Therapy Patients: a Systematic Review and Meta-Analysis

Szerző(k) neve és munkahelye

R. Masszi1, C. Turan2, A. Sayour1, E. Zsigmond3, R.Ehrenberger1 P. Hegyi2, P. Fehervari2, A. Kosztin1, B. Merkely1 - (1) Semmelweis University Heart and Vascular Center, Budapest, Hungary (2) Semmelweis University, Budapest, Hungary (3) Medical Centre, Hungarian Defence Forces, Budapest, Hungary

Bemutatás módja

Poszter

Szekció

Clinical Medicine - Posters A

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Introduction: Myocardial scar is associated with a higher prevalence of ventricular arrhythmias (VA) and sudden cardiac death (SCD). Late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR) can accurately evaluate the extent of myocardial scar. Clinical evidence suggests that scar assessment may help the decision of adding an implantable cardioverter defibrillator (ICD) to cardiac resynchronization therapy (CRT) to reduce the risk of VA and SCD.
Aims: In this systematic review and meta-analysis, we investigate the association between scar burden and SCD risk in cardiac resynchronization therapy patients.
Method: We performed a systematic literature search on MEDLINE using the PubMed, Embase, Scopus, and CENTRAL databases. The target population was patients with heart failure with reduced ejection fraction who underwent CRT. The primary endpoint was appropriate ICD shock. Meta-analyses were performed using the META and DMETAR packages in R, using a random-effects model. The risk of bias was assessed using RoB2 and the quality of evidence was evaluated using the GRADE assessment.
Results: Altogether 16 eligible articles have been included in our study, with a total of 2624 patients, of whom 601, 1220, and 391 have been implanted with an ICD, CRT-D, CRT-P respectively. Altogether 56 % of the total population were LGE-CMR positive, The proportion of appropriate ICD shock reached 18,58 % in the total population during the median follow-up time of 44 months.
The risk of developing sudden cardiac death events in the LGE positive population in articles using competing risk models was almost 48% higher (Hazard ratio 1,48, 95% Confidence interval: 0,75- 2,92) compared to LGE negative patients.
Conclusion: In our meta-analysis, LGE-CMR was associated with a trend toward appropriate device therapy and can identify a subgroup of patients with an increased risk of sudden cardiac death events. Based on our results performing an MRI before device implantation might be important to select the high-risk patients for SCD.
Funding: Semmelweis 250+ PhD fellowship program

University and Doctoral School

Semmelweis University, Doctoral School of Theoretical and Translational Medicine

Supervisor

Annamária Kosztin, Béla Merkely

Publication of my abstract

I do not give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

6887

Start

11:00

End

11:05

Authors (legacy)

R. Masszi1, C. Turan2, A. Sayour1, E. Zsigmond3, R.Ehrenberger1 P. Hegyi2, P. Fehervari2, A. Kosztin1, B. Merkely1 - (1) Semmelweis University Heart and Vascular Center, Budapest, Hungary (2) Semmelweis University, Budapest, Hungary (3) Medical Centre, Hungarian Defence Forces, Budapest, Hungary