Abstract:
BACKGROUND:Left ventricular ejection fraction (LVEF) ≤35% is the cutoff value used to identify patients at high risk of sudden cardiac death. However, whether patients who have moderate left ventricular dysfunction and left ventricular enlargement (LVE) have a high risk of ventricular arrhythmias (VAs) and cardiac death is unclear. HYPOTHESIS:Patients with moderate left ventricular dysfunction and LVE may have a high risk of VAs. METHODS:This study retrospectively analyzed the data of 853 patients who have an implantable cardioverter-defibrillator/cardiac resynchronization therapy cardioverter-defibrillator equipped with home monitoring. The patients were divided into 4 groups: group A, 35% < LVEF ≤ 45% and left ventricular end-diastolic dimension (LVEDD) ≥60 mm; group B, LVEF ≤35% and LVEDD <60 mm; group C, 35% < LVEF ≤ 45% and LVEDD <60 mm; and group D, LVEF ≤35% and LVEDD ≥60 mm. RESULTS:During a mean follow-up period of 30 ± 13 months, 324 patients (38%) experienced VAs and 125 patients (14.7%) experienced cardiac death. Based on multivariate Cox regression modeling, group A had an increased risk of VAs (A vs B, hazard ratio [HR]: 1.563, 95% confidence interval [CI]: 1.029-2.375, P = 0.036; A vs C, HR: 1.661, 95% CI: 1.204-2.294, P = 0.002) and cardiac death (A vs B, HR: 1.845, 95% CI: 1.013-3.356; A vs C, HR: 2.041, 95% CI: 1.136-3.731, P = 0.021). CONCLUSIONS:Patients with moderate left ventricular dysfunction and LVE have a high risk of VAs and cardiac death.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Zhao S,Chen K,Su Y,Hua W,Yang J,Chen S,Liang Z,Xu W,Zhang Sdoi
10.1002/clc.22588subject
Has Abstractpub_date
2016-12-01 00:00:00pages
703-708issue
12eissn
0160-9289issn
1932-8737journal_volume
39pub_type
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