Imaging modality for left ventricular ejection fraction estimation and effect of implantable cardioverter-defibrillator on mortality in patients with heart failure.
Imaging modality for left ventricular ejection fraction estimation and effect of implantable cardioverter-defibrillator on mortality in patients with heart failure.
- 2023
Available online through MWHC library: 2004 - present
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) improve outcomes in patients with heart failure (HF) with left ventricular ejection fraction (LVEF) <=35%. Less is known about whether outcomes varied between the 2 noninvasive imaging modalities used to estimate LVEF-2-dimensional echocardiography (2DE) and multigated acquisition radionuclide ventriculography (MUGA)-which use different principles (geometric vs count-based, respectively). CONCLUSION: We found no evidence that in patients with HF and LVEF <=35%, the effect of ICD on mortality varied by the noninvasive imaging method used to measure LVEF. Copyright � 2023 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. METHODS: Of the 2521 patients with HF with LVEF <=35% in the Sudden Cardiac Death in Heart Failure Trial, 1676 (66%) were randomized to either placebo or ICD, of whom 1386 (83%) had LVEF measured by 2DE (n = 971) or MUGA (n = 415). Hazard ratios (HRs) and 97.5% confidence intervals (CIs) for mortality associated with ICD were estimated overall, checking for interaction, and within the 2 imaging subgroups. OBJECTIVE: The purpose of this study was to examine whether the effect of ICD on mortality in patients with HF and LVEF <=35% varied on the basis of LVEF measured by 2DE or MUGA. RESULTS: Of the 1386 patients in the present analysis, all-cause mortality occurred in 23.1% (160 of 692) and 29.7% (206 of 694) of patients randomized to ICD or placebo, respectively (HR 0.77; 97.5% CI 0.61-0.97), which is consistent with that in 1676 patients in the original report. HRs (97.5% CIs) for all-cause mortality in the 2DE and MUGA subgroups were 0.79 (0.60-1.04) and 0.72 (0.46-1.11), respectively (P = .693 for interaction). Similar associations were observed for cardiac and arrhythmic mortalities.
English
1547-5271
10.1016/j.hrthm.2023.03.010 [doi] S1547-5271(23)00239-4 [pii]
IN PROCESS -- NOT YET INDEXED--Automated
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Cardiovascular Disease Fellowship
Internal Medicine Residency
MedStar Georgetown University Hospital/MedStar Washington Hospital Center
Journal Article
Available online through MWHC library: 2004 - present
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) improve outcomes in patients with heart failure (HF) with left ventricular ejection fraction (LVEF) <=35%. Less is known about whether outcomes varied between the 2 noninvasive imaging modalities used to estimate LVEF-2-dimensional echocardiography (2DE) and multigated acquisition radionuclide ventriculography (MUGA)-which use different principles (geometric vs count-based, respectively). CONCLUSION: We found no evidence that in patients with HF and LVEF <=35%, the effect of ICD on mortality varied by the noninvasive imaging method used to measure LVEF. Copyright � 2023 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. METHODS: Of the 2521 patients with HF with LVEF <=35% in the Sudden Cardiac Death in Heart Failure Trial, 1676 (66%) were randomized to either placebo or ICD, of whom 1386 (83%) had LVEF measured by 2DE (n = 971) or MUGA (n = 415). Hazard ratios (HRs) and 97.5% confidence intervals (CIs) for mortality associated with ICD were estimated overall, checking for interaction, and within the 2 imaging subgroups. OBJECTIVE: The purpose of this study was to examine whether the effect of ICD on mortality in patients with HF and LVEF <=35% varied on the basis of LVEF measured by 2DE or MUGA. RESULTS: Of the 1386 patients in the present analysis, all-cause mortality occurred in 23.1% (160 of 692) and 29.7% (206 of 694) of patients randomized to ICD or placebo, respectively (HR 0.77; 97.5% CI 0.61-0.97), which is consistent with that in 1676 patients in the original report. HRs (97.5% CIs) for all-cause mortality in the 2DE and MUGA subgroups were 0.79 (0.60-1.04) and 0.72 (0.46-1.11), respectively (P = .693 for interaction). Similar associations were observed for cardiac and arrhythmic mortalities.
English
1547-5271
10.1016/j.hrthm.2023.03.010 [doi] S1547-5271(23)00239-4 [pii]
IN PROCESS -- NOT YET INDEXED--Automated
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Cardiovascular Disease Fellowship
Internal Medicine Residency
MedStar Georgetown University Hospital/MedStar Washington Hospital Center
Journal Article