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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorSHIOZAKI, Afonso Akio-
dc.contributor.authorSENRA, Tiago-
dc.contributor.authorARTEAGA, Edmund-
dc.contributor.authorMARTINELLI FILHO, Martino-
dc.contributor.authorPITA, Cristiane Guedes-
dc.contributor.authorAVILA, Luis Francisco R.-
dc.contributor.authorPARGA FILHO, Jose Rodrigues-
dc.contributor.authorMADY, Charles-
dc.contributor.authorKALIL-FILHO, Roberto-
dc.contributor.authorBLUEMKE, David A.-
dc.contributor.authorROCHITTE, Carlos Eduardo-
dc.identifier.citationJOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, v.7, n.3, p.173-181, 2013-
dc.description.abstractBackground: Myocardial fibrosis (MF) occurs in up to 80% of subjects with asymptomatic or mildly symptomatic hypertrophic cardiomyopathy (HCM) and can constitute an arrhythmogenic substrate for re-entrant, life-threatening ventricular arrhythmias in predisposed persons. Objective: The aim was to investigate whether MF detected by delayed enhancement cardiac CT is predictive of ventricular tachycardia (VT) and fibrillation (VF) that require appropriate therapy by an implantable cardioverter defibrillator (ICD) in patients with HCM. Methods: Twenty-six patients with HCM with previously (for at least 1 year) implanted ICD underwent MF evaluation by cardiac CT. MF was quantified by myocardial delayed enhanced cardiac CT. Data on ICD firing were recorded every 3 months after ICD implantation. Risk factors for sudden cardiac death in patients with HCM were evaluated in all patients. Results: MF was present in 25 of 26 patients (96%) with mean fibrosis mass of 20.5 +/- 15.8 g. Patients with appropriate ICD shocks for VF/VT had significantly greater MF mass than patients without (29.10 +/- 19.13 g vs 13.57 +/- 8.31 g; P = .01). For a MF mass of at least 18 g, sensitivity and specificity for appropriate ICD firing were 73% (95% CI, 49%-88%) and 71% (95% CI, 56%-81%), respectively. Kaplan-Meier curves indicated a significantly greater VF/VT event rate in patients with MF mass >= 18 g than in patients with MF <18 g (P = .02). In the Cox regression analysis, the amount of MF was independently associated with VF/VT in ICD-stored electrograms. Conclusion: The mass of MF detected by cardiac CT in patients with HCM at high risk of sudden death was associated with appropriate ICD firings.-
dc.description.sponsorshipFAPESP (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo) [07/58876-8]-
dc.description.sponsorshipZerbini Foundation-
dc.description.sponsorshipBrazilian Society of Cardiology (Sociedade Brasileira de Cardiologia)-
dc.relation.ispartofJournal of Cardiovascular Computed Tomography-
dc.subjectHypertrophic cardiomyopathy-
dc.subjectMyocardial fibrosis-
dc.subjectVentricular arrhythmias-
dc.subjectDelayed enhancement cardiac computed tomography-
dc.subjectImplantable cardiac defibrillator-
dc.subject.othercardiovascular magnetic-resonance-
dc.subject.otherlate gadolinium enhancement-
dc.subject.otherbinding protein-c-
dc.subject.otherimplantable cardioverter-defibrillators-
dc.subject.othermultidetector computed-tomography-
dc.subject.otherdelayed enhancement-
dc.titleMyocardial fibrosis detected by cardiac CT predicts ventricular fibrillation/ventricular tachycardia events in patients with hypertrophic cardiomyopathy-
dc.rights.holderCopyright ELSEVIER SCIENCE INC-
dc.subject.wosCardiac & Cardiovascular Systems-
dc.subject.wosRadiology, Nuclear Medicine & Medical Imaging-
dc.type.categoryoriginal article-
dc.type.versionpublishedVersion-, Afonso Akio:Univ Sao Paulo, Sch Med, Heart Inst InCor, Cardiovasc Magnet Resonance & Computed Tomog Sect, Sao Paulo, Brazil-, Tiago:Univ Sao Paulo, Sch Med, Heart Inst InCor, Cardiovasc Magnet Resonance & Computed Tomog Sect, Sao Paulo, Brazil-, Cristiane Guedes:Univ Sao Paulo, Sch Med, Heart Inst InCor, Pacemaker Clin, Sao Paulo, Brazil-, David A.:NIH, Ctr Clin, Bethesda, MD 20892 USA-
hcfmusp.publisher.cityNEW YORK-
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hcfmusp.remissive.sponsorshipFund Zerbini-
Appears in Collections:

Artigos e Materiais de Revistas Científicas - FM/MCP
Departamento de Cardio-Pneumologia - FM/MCP

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/11
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação

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