Evidence map›Paper›PMID 34218421›Full record

SynthesisJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2022

The prognostic role of late gadolinium enhancement on cardiac magnetic resonance in patients with nonischemic cardiomyopathy and reduced ejection fraction, implanted with cardioverter defibrillators for primary prevention. A systematic review and meta-analysis.

Ioannis Anagnostopoulos, Maria Kousta, Charalampos Kossyvakis, Eleni Lakka, Nikolaos Taxiarchis Paraskevaidis, Nikolaos Schizas, Nikolaos Alexopoulos, Spyridon Deftereos, Georgios Giannopoulos

Abstract readMeta-AnalysisSystematic Review
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In one paragraph

Synthesis in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.5field-weighted citation impact, top 34% 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

5 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Ioannis AnagnostopoulosCardiology Department, Athens General Hospital "G. Gennimatas,", 154 Mesogion Avenue, 11527, Athens, Greece. iannis.anagnostopoulos@gmail.com.ORCID http://orcid.org/0000-0002-3062-360X
Maria KoustaCardiology Department, Athens General Hospital "G. Gennimatas,", 154 Mesogion Avenue, 11527, Athens, Greece.
Charalampos KossyvakisCardiology Department, Athens General Hospital "G. Gennimatas,", 154 Mesogion Avenue, 11527, Athens, Greece.
Eleni LakkaCardiology Department, Athens General Hospital "G. Gennimatas,", 154 Mesogion Avenue, 11527, Athens, Greece.
Nikolaos Taxiarchis ParaskevaidisCardiology Department, Athens General Hospital "G. Gennimatas,", 154 Mesogion Avenue, 11527, Athens, Greece.
Nikolaos SchizasDepartment of Cardiothoracic Surgery, Evangelismos Hospital, Athens, Greece.
Nikolaos Alexopoulos2nd Department of Cardiology, Athens Euroclinic, Athens, Greece.
Spyridon Deftereos2nd Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece.
Georgios GiannopoulosCardiology Department, Athens General Hospital "G. Gennimatas,", 154 Mesogion Avenue, 11527, Athens, Greece.
General Hospital of Athens G. Genimatas · GRAthens Euroclinic · GREvangelismos Hospital · GRNational and Kapodistrian University of Athens · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious studies suggest that late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) is associated with arrhythmic events in patients with nonischemic cardiomyopathy (NICM), while others have questioned the role of left ventricular ejection fraction (LVEF) as a sole predictor of future events.

objectivesTo evaluate the role of LGE on CMR in identifying patients with NICM and reduced LVEF for whom a benefit from defibrillator implantation for primary prevention is not anticipated, thus they are mainly exposed to potential risks.

methodsMajor electronic databases were searched for studies reporting the incidence of appropriate device therapy (ADT), sudden cardiac death (SCD), and cardiac death based on the presence of LGE on CMR, among patients with NICM and reduced LVEF, implanted with a cardioverter defibrillator for primary prevention.

resultsEleven studies (1652 patients, 947 with LGE) were included in the final analysis. LGE presence was strongly associated with ADT (logOR: 1.95, 95%CI: 1.21-2.69) and cardiac death (logOR: 0.91, 95%CI: 0.14-1.68), but not with SCD (logOR: 0.26, 95%CI: -1.09-1.6). Diagnostic accuracy analysis demonstrated that contrast enhancement is a sensitive marker of future ADT and cardiac death (93%, 95%CI: 85.8-96.7%; 82.9%, 95%CI: 70.6-90.7%; respectively), with moderate specificity ( 44%, 95%CI: 27.2-62.6%; 37.7%, 95%CI: 23.4-54.6%; respectively).

conclusionLGE is a highly sensitive predictor of ADT and cardiac death in NICM patients implanted with a defibrillator for primary prevention. However, due to moderate specificity, derivation of a cutoff with adequate predictive values and probably a multifactorial approach are needed to improve discrimination of patients who will not benefit from ICDs.

Indexed as

CardiomyopathiesDefibrillators, ImplantableVentricular Dysfunction, LeftContrast MediaDeath, Sudden, CardiacGadoliniumHumansMagnetic Resonance SpectroscopyPredictive Value of TestsPrimary PreventionPrognosisRisk FactorsStroke VolumeVentricular Function, LeftContrast MediaGadoliniumCardiac deathCardiac magnetic resonanceDilated cardiomyopathyICDImplantable cardioverter defibrillatorNonischemic cardiomyopathyPrognosisSudden cardiac deathVentricular arrhythmias

Identifiers

PMID34218421
OpenAlexW3182489575

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Registered trials

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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.