Utility of high-resolution magnetocardiography to predict later cardiac events in nonischemic cardiomyopathy patients with normal QRS duration

Shoji Kawakami, Hiroshi Takaki, Shuji Hashimoto, Yoshitaka Kimura, Takahiro Nakashima, Takeshi Aiba, Kengo F. Kusano, Shiro Kamakura, Satoshi Yasuda, Masaru Sugimachi

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Background: Nonischemic dilated cardiomyopathy (NIDCM) patients, even those with a narrow QRS, are at increased risk for major adverse cardiac events (MACE). We hypothesized that 64-channel magnetocardiography (MCG) would be useful to detect prognostic left intraventricular disorganized conduction (LiDC) by overcoming the limitations of fragmented QRS (fQRS, qualitative definitions, low specificity) and late potential (abnormality undetectable in earlier QRS). Methods and Results: We evaluated LiDC on MCG, defined as significant deviation from a global clockwise left ventricular (LV) activation pattern, and conventional noninvasive predictors of MACE, including fQRS and late potential, in 51 NIDCM patients with narrow QRS (LV ejection fraction, 22 ± 7%; QRS duration, 99 ± 11 ms). MACE was defined as cardiac death, lethal ventricular arrhythmias, or LV assist device (LVAD) implantation. LiDC was present in 22 patients. Baseline characteristics were comparable between patients with and without LiDC, except for the ratio of positive late potential. During a mean follow-up of 2.9 years, MACE developed in 16 NIDCM patients (3 cardiac deaths, 9 lethal ventricular arrhythmias, and 4 LVAD). MACE was more incident in patients with LiDC (13/22) than in those without (3/29, P<0.001). Multivariate analysis revealed LiDC, but not fQRS or late potential, as the strongest independent predictor of MACE (hazard ratio 4.28, 95% confidence interval 1.30–19.39, P=0.015). Conclusions: MCG accurately depicts LiDC, a promising noninvasive predictor of MACE in patients with NIDCM and normal QRS.

Original languageEnglish
Pages (from-to)44-51
Number of pages8
JournalCirculation Journal
Volume81
Issue number1
DOIs
Publication statusPublished - 2017

Keywords

  • Cardiomyopathy
  • Conduction block
  • Heart failure
  • Magnetocardiography
  • Tachyarrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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