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Zhang L, Lin Y, Wang K, Han L, Zhang X, Gao X, Li Z, Zhang H, Zhou J, Yu H, Fu X. Multiple-model machine learning identifies potential functional genes in dilated cardiomyopathy. Front Cardiovasc Med 2023; 9:1044443. [PMID: 36712235 PMCID: PMC9874116 DOI: 10.3389/fcvm.2022.1044443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Machine learning (ML) has gained intensive popularity in various fields, such as disease diagnosis in healthcare. However, it has limitation for single algorithm to explore the diagnosing value of dilated cardiomyopathy (DCM). We aim to develop a novel overall normalized sum weight of multiple-model MLs to assess the diagnosing value in DCM. Methods Gene expression data were selected from previously published databases (six sets of eligible microarrays, 386 samples) with eligible criteria. Two sets of microarrays were used as training; the others were studied in the testing sets (ratio 5:1). Totally, we identified 20 differently expressed genes (DEGs) between DCM and control individuals (7 upregulated and 13 down-regulated). Results We developed six classification ML methods to identify potential candidate genes based on their overall weights. Three genes, serine proteinase inhibitor A3 (SERPINA3), frizzled-related proteins (FRPs) 3 (FRZB), and ficolin 3 (FCN3) were finally identified as the receiver operating characteristic (ROC). Interestingly, we found all three genes correlated considerably with plasma cells. Importantly, not only in training sets but also testing sets, the areas under the curve (AUCs) for SERPINA3, FRZB, and FCN3 were greater than 0.88. The ROC of SERPINA3 was significantly high (0.940 in training and 0.918 in testing sets), indicating it is a potentially functional gene in DCM. Especially, the plasma levels in DCM patients of SERPINA3, FCN, and FRZB were significant compared with healthy control. Discussion SERPINA3, FRZB, and FCN3 might be potential diagnosis targets for DCM, Further verification work could be implemented.
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Affiliation(s)
- Lin Zhang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yexiang Lin
- Biomedical Engineering, Imperial College London, London, United Kingdom
| | - Kaiyue Wang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lifeng Han
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xue Zhang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiumei Gao
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zheng Li
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | | | - Jiashun Zhou
- Tianjin Jinghai District Hospital, Tianjin, China
| | - Heshui Yu
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China,*Correspondence: Heshui Yu,
| | - Xuebin Fu
- Department of Cardiovascular-Thoracic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States,Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, United States,Xuebin Fu,
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Burger H, Schmitt J, Knaut M, Eitz T, Starck CT, Hakmi S, Siebel A, Böning A. Einsatz des tragbaren Kardioverter-Defibrillators nach kardiochirurgischen Eingriffen. ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2018. [DOI: 10.1007/s00398-018-0246-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Röger S, Rosenkaimer SL, Hohneck A, Lang S, El-Battrawy I, Rudic B, Tülümen E, Stach K, Kuschyk J, Akin I, Borggrefe M. Therapy optimization in patients with heart failure: the role of the wearable cardioverter-defibrillator in a real-world setting. BMC Cardiovasc Disord 2018; 18:52. [PMID: 29544442 PMCID: PMC5856002 DOI: 10.1186/s12872-018-0790-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 03/08/2018] [Indexed: 12/15/2022] Open
Abstract
Background The wearable cardioverter-defibrillator (WCD) has emerged as a valuable tool to temporarily protect patients at risk for sudden cardiac death (SCD). The aim of this study was to determine the value of the WCD for therapy optimization of heart failure patients. Methods One hundred five consecutive patients that received WCD between 4/2012 and 9/2016 were included in the study. All patients were followed for clinical outcome and echocardiographic parameters during WCD therapy and had continued follow-up after WCD therapy, irrespective of subsequent implantable cardioverter-defibrillator (ICD) implantation. Results The most common indication for WCD were newly diagnosed ischemic (ICM) or non-ischemic cardiomyopathy (NICM) with left ventricular ejection fraction (LVEF) ≤35%. Mean WCD wear time was 68.8 ± 50.4 days with a mean daily use of 21.5 ± 3.5 h. Five patients (4.8%) received a total of five appropriate WCD shocks. During WCD wear, patients with ICM and NICM showed significant improvement in LVEF, reducing the proportion of patients with a need for primary preventive ICD implantation to 54.8% (ICM) and 48.8% (NICM). An ICD was finally implanted in 51.4% of the study patients (24 trans-venous ICDs, 30 subcutaneous ICDs). After discontinuation of WCD therapy, all patients were followed for a mean of 18.6 ± 12.3 months. 5.6% of patients with implanted ICDs received appropriate therapies. No patient with subcutaneous ICD needed change to a trans-venous device. None of the patients without an implanted ICD suffered from ventricular tachyarrhythmias and no patient died suddenly. In patients with NICM a significant LVEF improvement was observed during long-term follow-up (from 34.8 ± 11.1% to 41.0 ± 10.2%). Conclusions WCD therapy successfully bridged all patients to either LVEF recovery or ICD implantation. Following WCD, ICD implantation could be avoided in almost half of the patients. In selected patients, prolongation of WCD therapy beyond 3 months might further prevent unnecessary ICD implantation. The WCD as an external monitoring system contributed important information to optimize device selection in patients that needed ICD implantation.
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Affiliation(s)
- Susanne Röger
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. .,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany.
| | - Stefanie L Rosenkaimer
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Anna Hohneck
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Siegfried Lang
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Ibrahim El-Battrawy
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Boris Rudic
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Erol Tülümen
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Ksenija Stach
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Jürgen Kuschyk
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Ibrahim Akin
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Martin Borggrefe
- First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
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Pillarisetti J, Gopinathannair R, Haney MJ, Abazid B, Rawasia W, Reddy MY, Adabala N, Bommana S, Emert M, Lakkireddy D. Risk of ventricular tachyarrhythmias following improvement of left ventricular ejection fraction in patients with implantable cardiac defibrillators implanted for primary prevention of sudden cardiac death. J Interv Card Electrophysiol 2017; 48:283-289. [DOI: 10.1007/s10840-017-0222-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 01/04/2017] [Indexed: 11/29/2022]
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KIM MINSU, KIM JUN, LEE JIHYUN, HWANG YOUMI, KIM MINSEOK, NAM GIBYOUNG, CHOI KEEJOON, KIM JAEJOONG, KIM YOUHO. Impact of Improved Left Ventricular Systolic Function on the Recurrence of Ventricular Arrhythmia in Heart Failure Patients With an Implantable Cardioverter-Defibrillator. J Cardiovasc Electrophysiol 2016; 27:1191-1198. [DOI: 10.1111/jce.13037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 06/07/2016] [Accepted: 06/13/2016] [Indexed: 11/27/2022]
Affiliation(s)
- MINSU KIM
- Heart Institute, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - JUN KIM
- Heart Institute, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - JI HYUN LEE
- Heart Institute, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - YOU MI HWANG
- Heart Institute, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - MIN-SEOK KIM
- Heart Institute, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - GI-BYOUNG NAM
- Heart Institute, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - KEE-JOON CHOI
- Heart Institute, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - JAE-JOONG KIM
- Heart Institute, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
| | - YOU-HO KIM
- Heart Institute, Asan Medical Center; University of Ulsan College of Medicine; Seoul Republic of Korea
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BERTHELOT-RICHER MAXIME, BONENFANT FRANCIS, CLAVEL MARIEANNICK, FARAND PAUL, PHILIPPON FRANÇOIS, AYALA-PAREDES FELIX, ESSADIQI BTISSAMA, BADRA-VERDU MG, ROUX JEANFRANÇOIS. Arrhythmic Risk Following Recovery of Left Ventricular Ejection Fraction in Patients with Primary Prevention ICD. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2016; 39:680-9. [DOI: 10.1111/pace.12868] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 03/16/2016] [Accepted: 03/26/2016] [Indexed: 11/29/2022]
Affiliation(s)
| | - FRANCIS BONENFANT
- Department of Medicine, Cardiovascular Division; Centre Hospitalier Universitaire de Sherbrooke; Quebec Canada
| | - MARIE-ANNICK CLAVEL
- Faculty of Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Québec; Université Laval; Quebec City Quebec Canada
| | - PAUL FARAND
- Department of Medicine, Cardiovascular Division; Centre Hospitalier Universitaire de Sherbrooke; Quebec Canada
| | - FRANÇOIS PHILIPPON
- Faculty of Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Québec; Université Laval; Quebec City Quebec Canada
| | - FELIX AYALA-PAREDES
- Department of Medicine, Cardiovascular Division; Centre Hospitalier Universitaire de Sherbrooke; Quebec Canada
| | - BTISSAMA ESSADIQI
- Department of Medicine, Cardiovascular Division; Centre Hospitalier Universitaire de Sherbrooke; Quebec Canada
| | - Mariano Gonzalo BADRA-VERDU
- Department of Medicine, Cardiovascular Division; Centre Hospitalier Universitaire de Sherbrooke; Quebec Canada
| | - JEAN-FRANÇOIS ROUX
- Department of Medicine, Cardiovascular Division; Centre Hospitalier Universitaire de Sherbrooke; Quebec Canada
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Tachi M, Amano Y, Inui K, Takeda M, Yamada F, Asai K, Kumita S. Relationship of postcontrast myocardial T1 value and delayed enhancement to reduced cardiac function and serious arrhythmia in dilated cardiomyopathy with left ventricular ejection fraction less than 35. Acta Radiol 2016; 57:430-6. [PMID: 25900838 DOI: 10.1177/0284185115580840] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 03/04/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dilated cardiomyopathy (DCM) is often associated with progressive heart failure or ventricular arrhythmia. Look-Locker magnetic resonance imaging (MRI) allows quantitative evaluation of interstitial fibrosis by measuring the myocardial T1 value, and delayed enhancement (DE) MRI visualizes myocardial scar. PURPOSE To determine the relationship of postcontrast myocardial T1 value or DE to reduced cardiac function or sustained ventricular tachycardia (SVT) in DCM patients with a left ventricular ejection fraction (LVEF) <35%. MATERIAL AND METHODS We enrolled 41 patients with DCM. Correlations between the cardiac function parameters and postcontrast myocardial T1 value or extent of DE were evaluated. The relationship between SVT and the T1 values or extent of DE was assessed. The correlation between the extent of DE and the T1 value was also examined. RESULTS The postcontrast myocardial T1 value was significantly correlated with the LVEF (P < 0.05; r = 0.31) and end-diastolic volume (P < 0.01; r = -0.40) in 40 patients with LVEF <35%. DE was not correlated with the cardiac function, but provided a high negative predictive value of 94.7% for SVT. No correlation was found between the myocardial T1 value and extent of DE. CONCLUSION In DCM patients with LVEF <35%, the postcontrast myocardial T1 value correlated with the severity of cardiac dysfunction, and the absence of DE indicated the low risk of SVT. Both MRI parameters should be estimated because they may reflect discrete forms of myocardial damages in patients with DCM.
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Affiliation(s)
- Masaki Tachi
- Department of Radiology, Nippon Medical School, Tokyo, Japan
| | - Yasuo Amano
- Department of Radiology, Nippon Medical School, Tokyo, Japan
| | - Kensuke Inui
- Department of Cardiology, Nippon Medical School, Tokyo, Japan
| | - Minako Takeda
- Department of Radiology, Nippon Medical School, Tokyo, Japan
| | - Fumi Yamada
- Department of Radiology, Nippon Medical School, Tokyo, Japan
| | - Kuniya Asai
- Department of Cardiology, Nippon Medical School, Tokyo, Japan
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Normalization of Left Ventricular Ejection Fraction and Incidence of Appropriate Antitachycardia Therapy in Patients With Implantable Cardioverter Defibrillator for Primary Prevention of Sudden Death. J Card Fail 2016; 22:125-32. [DOI: 10.1016/j.cardfail.2015.10.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 10/09/2015] [Accepted: 10/22/2015] [Indexed: 11/23/2022]
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Cygankiewicz I, Ptaszynski P. Restratification at time of implantable cardioverter defibrillator replacement. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2014; 67:971-973. [PMID: 25444380 DOI: 10.1016/j.rec.2014.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 07/04/2014] [Indexed: 06/04/2023]
Affiliation(s)
| | - Pawel Ptaszynski
- Department of Electrocardiology, Medical University of Lodz, Poland
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Reestratificación en el momento del recambio del desfibrilador automático implantable. Rev Esp Cardiol (Engl Ed) 2014. [DOI: 10.1016/j.recesp.2014.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Grimm W, Timmesfeld N, Efimova E. Left ventricular function improvement after prophylactic implantable cardioverter-defibrillator implantation in patients with non-ischaemic dilated cardiomyopathy. Europace 2013; 15:1594-600. [DOI: 10.1093/europace/eut097] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Guglin M, Verma S, Chen R. Association Between Weight Loss and Improvement of Ventricular Systolic Function in Advanced Heart Failure. ACTA ACUST UNITED AC 2013; 19:186-91. [DOI: 10.1111/chf.12024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 12/16/2012] [Accepted: 01/08/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Maya Guglin
- Department of Cardiology; University of South Florida; Tampa; FL
| | - Sameer Verma
- Department of Cardiology; University of South Florida; Tampa; FL
| | - Ren Chen
- Department of Cardiology; University of South Florida; Tampa; FL
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Abstract
OPINION STATEMENT Advanced heart failure (HF) is a condition that is rarely thought of in terms of cure. Left ventricular assist devices (LVADs), like no therapy before them, provide complete decongestion of the left ventricle, with resulting favorable changes at all levels, from reversal of hypertrophy of cardiomyocytes to recovery of normal geometry and function of the ventricles. Although not a frequent phenomenon at most institutions, LV recovery is achieved in 20-25 % of LVAD recipients in some programs. Patients with good chances for recovery are usually young, with nonischemic cardiomyopathy and short duration of HF symptoms. After LVAD removal, patients with recovered function remain asymptomatic for years. To reach this level of sustainable restoration of cardiac function, several steps need to be taken: 1) myocardial recovery has to be recognized as a therapeutic goal, especially in patients with nonischemic cardiomyopathy; 2) HF medications have to be restarted and aggressively uptitrated after LVAD implantation; 3) regular monitoring for signs of myocardial recovery (eg, echocardiography or hemodynamics) should become a standard practice in LVAD centers; and 4) weaning protocols should be discussed and accepted at each LVAD program. While some protocols involve extensive several-day testing both at rest and with exercise, others are mostly guided by echocardiographic evaluation.
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Littmann L, Narveson SY, Fesel NM, Marconi SL. Timing of prophylactic implantable cardioverter-defibrillator implantation in patients with cardiomyopathy. Am J Cardiol 2012; 110:161-2. [PMID: 22704297 DOI: 10.1016/j.amjcard.2012.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 04/10/2012] [Indexed: 11/16/2022]
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Elliott PM, Mohiddin SA. Almanac 2011: Cardiomyopathies. The national society journals present selected research that has driven recent advances in clinical cardiology. Egypt Heart J 2012. [DOI: 10.1016/j.ehj.2012.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Elliott PM, Mohiddin SA. Almanac 2011: Cardiomyopathies. The national society journals present selected research that has driven recent advances in clinical cardiology. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.repce.2012.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Zecchin M, Merlo M, Pivetta A, Barbati G, Lutman C, Gregori D, Serdoz LV, Bardari S, Magnani S, Di Lenarda A, Proclemer A, Sinagra G. How can optimization of medical treatment avoid unnecessary implantable cardioverter-defibrillator implantations in patients with idiopathic dilated cardiomyopathy presenting with "SCD-HeFT criteria?". Am J Cardiol 2012; 109:729-35. [PMID: 22176998 DOI: 10.1016/j.amjcard.2011.10.033] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 10/25/2011] [Accepted: 10/25/2011] [Indexed: 10/14/2022]
Abstract
To assess the proportion and long-term outcomes of patients with idiopathic dilated cardiomyopathy and potential indications for implantable cardioverter-defibrillator before and after optimization of medical treatment, 503 consecutive patients with idiopathic dilated cardiomyopathy were evaluated from 1988 to 2006. A total of 245 patients (49%) satisfied the "Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) criteria," defined as a left ventricular ejection fraction of ≤0.35 and New York Heart Association (NYHA) class II-III on registration. Among these, 162 (group A) were re-evaluated 5.4 ± 2 months later with concurrent β-blockers and angiotensin-converting enzyme inhibitor use. Of the 162 patients, 50 (31%) still had "SCD-HeFT criteria" (group A1), 109 (67%) had an improved left ventricular ejection fraction and/or New York Heart Association class (group A2), and 3 (2%) were in NYHA class IV. Of the 227 patients without baseline "SCD-HeFT criteria" (left ventricular ejection fraction >0.35 or NYHA class I), 125 were evaluated after 5.5 ± 2 months. Of these 227 patients, 13 (10%) developed "SCD-HeFT criteria" (group B1), 111 (89%) remained without "SCD-HeFT criteria" (group B2), and 1 (1%) had worsened to NYHA class IV. The 10-year mortality/heart transplantation and sudden death/sustained ventricular arrhythmia rate was 57% and 37% in group A1, 23% and 20% in group A2 (p <0.001 for mortality/heart transplantation and p = 0.014 for sudden death/sustained ventricular arrhythmia vs group A1), 45% and 41% in group B1 (p = NS vs group A1), 16% and 14% in group B2 (p = NS vs group A2), respectively. In conclusion, two thirds of patients with idiopathic dilated cardiomyopathy and "SCD-HeFT criteria" at presentation did not maintain implantable cardioverter-defibrillator indications 3 to 9 months later with optimal medical therapy. Their long-term outcome was excellent, similar to that observed for patients who had never met the "SCD-HeFT criteria."
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Almanac 2011: Cardiomyopathies. The national society journals present selected research that has driven recent advances in clinical cardiology. Rev Port Cardiol 2012; 31:255-61. [DOI: 10.1016/j.repc.2012.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 01/04/2012] [Indexed: 11/23/2022] Open
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Hoogwegt MT, Kupper N, Theuns DAMJ, Jordaens L, Pedersen SS. Beta-blocker therapy is not associated with symptoms of depression and anxiety in patients receiving an implantable cardioverter-defibrillator. Europace 2011; 14:74-80. [DOI: 10.1093/europace/eur295] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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