Evidence map›Paper›PMID 31864974›Full record

ArticleJACC. Cardiovascular imaging2020

CMR DENSE and the Seattle Heart Failure Model Inform Survival and Arrhythmia Risk After CRT.

Kenneth C Bilchick, Daniel A Auger, Mohammad Abdishektaei, Roshin Mathew, Min-Woong Sohn, Xiaoying Cai, Changyu Sun, Aditya Narayan, Rohit Malhotra, Andrew Darby and 8 more

Open access · greenAbstract read
In one paragraph

Article in JACC. Cardiovascular imaging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 3 pooled it
3.2field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.

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  11. MULTIMODAL LEARNING TO IMPROVE CARDIAC LATE MECHANICAL ACTIVATION DETECTION FROM CINE MR IMAGES.Proceedings. IEEE International Symposium on Biomedical Imaging · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 2 institutions in 1 country.

Kenneth C BilchickDepartment of Medicine, University of Virginia Health System, Charlottesville, Virginia. Electronic address: bilchick@virginia.edu.
Daniel A AugerDepartment of Biomedical Engineering, University of Virginia Health System, Charlottesville, Virginia.
Mohammad AbdishektaeiDepartment of Biomedical Engineering, University of Virginia Health System, Charlottesville, Virginia.
Roshin MathewDepartment of Medicine, University of Virginia Health System, Charlottesville, Virginia.
Min-Woong SohnDepartment of Public Health Sciences, University of Virginia Health System, Charlottesville, Virginia.
Xiaoying CaiDepartment of Biomedical Engineering, University of Virginia Health System, Charlottesville, Virginia.
Changyu SunDepartment of Biomedical Engineering, University of Virginia Health System, Charlottesville, Virginia.
Aditya NarayanDepartment of Biomedical Engineering, University of Virginia Health System, Charlottesville, Virginia.
Rohit MalhotraDepartment of Medicine, University of Virginia Health System, Charlottesville, Virginia.
Andrew DarbyDepartment of Medicine, University of Virginia Health System, Charlottesville, Virginia.
J Michael MangrumDepartment of Medicine, University of Virginia Health System, Charlottesville, Virginia.
Nishaki MehtaDepartment of Medicine, University of Virginia Health System, Charlottesville, Virginia.
John FergusonDepartment of Medicine, University of Virginia Health System, Charlottesville, Virginia.
Sula MazimbaDepartment of Medicine, University of Virginia Health System, Charlottesville, Virginia.
Pamela K MasonDepartment of Medicine, University of Virginia Health System, Charlottesville, Virginia.
Christopher M KramerDepartment of Medicine, University of Virginia Health System, Charlottesville, Virginia; Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia.
Wayne C LevyDepartment of Medicine, University of Washington, Seattle, Washington.
Frederick H EpsteinDepartment of Biomedical Engineering, University of Virginia Health System, Charlottesville, Virginia; Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia.
University of Virginia Health System · USUniversity of Washington · US

Funding

MRI of Mechanical Activation and Scar for Optimal Cardiac Resynchronization Therapy ImplementationR56HL135556 · NHLBI · UNIVERSITY OF VIRGINIA · PI BILCHICK, KENNETH C · 2017 to 2017
$711k
Risk Stratification for ICD Generator Changes in the ICD RegistryR21HL140445 · NHLBI · UNIVERSITY OF VIRGINIA · PI BILCHICK, KENNETH C · 2018 to 2019
$255k
NHLBI NIH HHS R21 HL140445NHLBI NIH HHS R56 HL135556
6 · The paper itself

Abstract

objectivesThis study sought to determine if combining the Seattle Heart Failure Model (SHFM-D) and cardiac magnetic resonance (CMR) provides complementary prognostic data for patients with cardiac resynchronization therapy (CRT) defibrillators.

backgroundThe SHFM-D is among the most widely used risk stratification models for overall survival in patients with heart failure and implantable cardioverter-defibrillators (ICDs), and CMR provides highly detailed information regarding cardiac structure and function.

methodsCMR Displacement Encoding with Stimulated Echoes (DENSE) strain imaging was used to generate the circumferential uniformity ratio estimate with singular value decomposition (CURE-SVD) circumferential strain dyssynchrony parameter, and the SHFM-D was determined from clinical parameters. Multivariable Cox proportional hazards regression was used to determine adjusted hazard ratios and time-dependent areas under the curve for the primary endpoint of death, heart transplantation, left ventricular assist device, or appropriate ICD therapies.

resultsThe cohort consisted of 100 patients (65.5 [interquartile range 57.7 to 72.7] years; 29% female), of whom 47% had the primary clinical endpoint and 18% had appropriate ICD therapies during a median follow-up of 5.3 years. CURE-SVD and the SHFM-D were independently associated with the primary endpoint (SHFM-D: hazard ratio: 1.47/SD; 95% confidence interval: 1.06 to 2.03; p = 0.02) (CURE-SVD: hazard ratio: 1.54/SD; 95% confidence interval: 1.12 to 2.11; p = 0.009). Furthermore, a favorable prognostic group (Group A, with CURE-SVD <0.60 and SHFM-D <0.70) comprising approximately one-third of the patients had a very low rate of appropriate ICD therapies (1.5% per year) and a greater (90%) 4-year survival compared with Group B (CURE-SVD ≥0.60 or SHFM-D ≥0.70) patients (p = 0.02). CURE-SVD with DENSE had a stronger correlation with CRT response (r = -0.57; p < 0.0001) than CURE-SVD with feature tracking (r = -0.28; p = 0.004).

conclusionsA combined approach to risk stratification using CMR DENSE strain imaging and a widely used clinical risk model, the SHFM-D, proved to be effective in this cohort of patients referred for CRT defibrillators. The combined use of CMR and clinical risk models represents a promising and novel paradigm to inform prognosis and device selection in the future.

Indexed as

Cardiac Resynchronization TherapyDecision Support TechniquesElectric CountershockMagnetic Resonance Imaging, CineAgedArrhythmias, CardiacCardiac Resynchronization Therapy DevicesDefibrillators, ImplantableFemaleHeart FailureHumansMaleMiddle AgedPredictive Value of TestsRisk AssessmentRisk Factorscardiac magnetic resonancecardiac resynchronization therapyheart failureimplantable cardioverter-defibrillatorrisk models

Identifiers

PMID31864974
PMCPMC7774038
OpenAlexW2996179920

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.