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- Title
Left ventricular sphericity index analysis for the prediction of appropriate implantable cardioverter‐defibrillator therapy.
- Authors
Anvari, Shideh; Akbarzadeh, Mohammad Ali; Bayat, Fariba; Namazi, Mohammad Hasan; Safi, Morteza
- Abstract
Abstract: Background: Implantable cardioverter‐defibrillator (ICD) is the most effective therapy currently available to prevent sudden cardiac death (SCD) in patients with left ventricular (LV) dysfunction. Although LV ejection fraction (LVEF) is an excellent marker of SCD in these patients, determining other predictors might help to identify patients who will be benefit more from device implantation. The purpose of this study was to determine whether abnormal LV sphericity index (SI) in transthoracic echocardiography is associated with appropriate ICD therapy in these patients. Methods: A total of 140 patients with primary ICD implantation (mean age 62.59 ± 11.36 years; 98 [70%] male) were included. The patients were classified into “no ICD therapy” or “ICD therapy” group according to the information of their devices for a maximum of 2 previous years. In four‐chamber view image of transthoracic echocardiography, SI was calculated by dividing the major‐axis dimension to minor‐axis dimension of LV in both groups. Results: Compared with patients with no ICD therapy, patients in ICD therapy group had lower LVEF (31.36 ± 9.58 vs 23.24 ± 6.03, P = 0.0001) and lower SI (1.79 ± 0.29 vs 1.57 ± 0.32, P = 0.0001). In multivariant logistic regression analysis, the SI of ≤1.58 was associated with fourfold increase of appropriate ICD therapy, even after adjusting for LVEF (odds ratio, 4.08; 95% confidence interval, 1.71–9.75; P = 0.02). Conclusion: Simple echocardiographic sphericity dimension index as a marker of cardiac remodeling may be an important predictor of appropriate ICD therapy in patients with primary prevention ICDs and may provide additive risk stratification in patients with LV systolic dysfunction.
- Subjects
HEART ventricle diseases; BIOMARKERS; CARDIAC arrest; CONFIDENCE intervals; ECHOCARDIOGRAPHY; LEFT heart ventricle; IMPLANTABLE cardioverter-defibrillators; MULTIVARIATE analysis; MULTIPLE regression analysis; VENTRICULAR remodeling; TREATMENT effectiveness; PATIENT selection; ODDS ratio; VENTRICULAR ejection fraction
- Publication
Pacing & Clinical Electrophysiology, 2018, Vol 41, Issue 9, p1192
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/pace.13420