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Asymptomatic Patients Without Known Heart Disease Have Markers of Occult Heart Disease

The American journal of cardiology, 2020-05, Vol.125 (9), p.1449-1450 [Peer Reviewed Journal]

2020 Elsevier Inc. ;2020. Elsevier Inc. ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2020.01.032 ;PMID: 32147089

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Title:
Asymptomatic Patients Without Known Heart Disease Have Markers of Occult Heart Disease
Author: Tamariz, Leonardo ; Palacio, Ana ; Myerburg, Robert ; Fishman, Joel ; Goldberger, Jeffrey J.
Subjects: Aged ; Asymptomatic Diseases ; Autonomic nervous system ; Cardiac stress tests ; Cardiomyopathies - complications ; Cardiomyopathies - diagnosis ; Cardiovascular disease ; Cardiovascular diseases ; Conflicts of interest ; Coronary artery disease ; Cross-Sectional Studies ; Death, Sudden, Cardiac - etiology ; Diabetes ; Evaluation ; Female ; Fibrosis ; Fibrosis - complications ; Fibrosis - diagnosis ; Gadolinium ; Genetic screening ; Health risks ; Health surveys ; Heart diseases ; Heart rate ; Humans ; Magnetic resonance imaging ; Male ; Middle Aged ; Myocardium - pathology ; Nucleotides ; Pilot Projects ; Recovery ; Risk ; Risk Assessment ; Signs and symptoms ; Single-nucleotide polymorphism ; Ventricle
Is Part Of: The American journal of cardiology, 2020-05, Vol.125 (9), p.1449-1450
Description: Left ventricular dysfunction is a significant predictor of sudden cardiac death (SCD); however, more SCDs occur among patients with preserved/minimally depressed left ventricular function.1 Both myocardial fibrosis as identified by late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) and abnormal heart rate recovery (HRR) as a measure of autonomic balance have been associated with SCD.2 However, myocardial fibrosis and abnormal HRR have mostly been evaluated as predictors of SCD in populations with significant heart disease.2 Identifying fibrosis and autonomic imbalance in earlier stages can provide an opportunity for intervention. [...]our aim was to conduct a pilot study on patients without heart disease but with a high SCD risk score and determine if those patients have myocardial fibrosis and abnormal heart rate recovery. To be included, patients were first identified to be in the upper 2 deciles of SCD risk as determined by a validated race-based SCD score which calculates the 10-year SCD risk.3 Patients underwent social determinants of health survey, CMR to identify myocardial fibrosis using LGE, stress test to evaluate 1-minute HRR, and genetic testing to identify specific single nucleotide polymorphisms associated with SCD.4 We included 11 patients without cardiovascular symptoms or work-up with a median SCD score of 2; interquartile range (IQR; 1.5 to 9). If our findings are reproduced in a larger study, we should evaluate the efficacy and cost-effectiveness of combining personalized cardiovascular testing with risk scores6 at identifying and reducing the risk of CVD events including SCD.Disclosures The authors have no conflicts of interest to disclose.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0002-9149
EISSN: 1879-1913
DOI: 10.1016/j.amjcard.2020.01.032
PMID: 32147089
Source: MEDLINE
ProQuest Central

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Asymptomatic Patients Without Known Heart Disease Have Markers of Occult Heart Disease

2020 Elsevier Inc. ;2020. Elsevier Inc. ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/j.amjcard.2020.01.032 ;PMID: 32147089

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