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Review
. 2023 Jun;25(6):525-534.
doi: 10.1007/s11886-023-01871-0. Epub 2023 Apr 10.

Prediction of Sudden Cardiac Death: Looking Beyond Ejection Fraction

Neal A Chatterjee  1
Affiliations
Review

Prediction of Sudden Cardiac Death: Looking Beyond Ejection Fraction

Neal A Chatterjee. Curr Cardiol Rep. 2023 Jun.

Abstract

Purpose of review: Sudden cardiac death (SCD) is a major public health burden accounting for 15-20% of global mortality. Contemporary guidelines for SCD prevention are centered around the presence of low left ventricular ejection fraction, although the majority of SCD accrues in those not meeting contemporary criteria for SCD prevention. The goal of this review is to elaborate on the contemporary landscape of SCD prediction tools and further highlight gaps and opportunities in SCD prediction and prevention.

Recent findings: There have been considerable advancements in both non-invasive and invasive measures for SCD risk prediction including clinical morbidities, electrocardiographic measures, cardiac imaging (nuclear, magnetic resonance, computed tomography), serum biomarkers, genetics, and invasively assessed electrophysiological characteristics. Novel methodological approaches including application of machine learning, incorporation of competing risk, and use of computational modeling have underscored a future of personalized risk prediction. SCD remains a vital public health challenge. Emerging methods highlight opportunities to improve SCD prediction in the majority of those at risk who do not meet contemporary criteria for SCD prevention therapies. Future efforts will need to focus on easily deployed, multi-parametric risk models that enrich for SCD risk and not for competing mortality.

Keywords: Cardiac magnetic resonance imaging; Epidemiology; Left ventricular ejection fraction; Risk prediction; Sudden cardiac death.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Hayashi M, Shimizu W, Albert CM. The spectrum of epidemiology underlying sudden cardiac death. Circ Res. 2015;116(12):1887–906. https://doi.org/10.1161/circresaha.116.304521 . - DOI - PubMed - PMC
    1. Tung R, Zimetbaum P, Josephson ME. A critical appraisal of implantable cardioverter-defibrillator therapy for the prevention of sudden cardiac death. J Am Coll Cardiol. 2008;52(14):1111–21. https://doi.org/10.1016/j.jacc.2008.05.058 . - DOI - PubMed
    1. Stecker EC, Vickers C, Waltz J, Socoteanu C, John BT, Mariani R, et al. Population-based analysis of sudden cardiac death with and without left ventricular systolic dysfunction: two-year findings from the Oregon Sudden Unexpected Death Study. J Am Coll Cardiol. 2006;47(6):1161–6. https://doi.org/10.1016/j.jacc.2005.11.045 . - DOI - PubMed
    1. Kober L, Thune JJ, Nielsen JC, Haarbo J, Videbaek L, Korup E, et al. Defibrillator implantation in patients with nonischemic systolic heart failure. N Engl J Med. 2016;375(13):1221–30. https://doi.org/10.1056/NEJMoa1608029 . - DOI - PubMed
    1. Shen L, Jhund PS, Petrie MC, Claggett BL, Barlera S, Cleland JGF, et al. Declining risk of sudden death in heart failure. N Engl J Med. 2017;377(1):41–51. https://doi.org/10.1056/NEJMoa1609758 . - DOI - PubMed
References
    1. Langer C, Lutz M, Eden M, Lüdde M, Hohnhorst M, Gierloff C, et al. Hypertrophic cardiomyopathy in cardiac CT: a validation study on the detection of intramyocardial fibrosis in consecutive patients. Int J Cardiovasc Imaging. 2014;30(3):659–67. https://doi.org/10.1007/s10554-013-0358-8 . - DOI - PubMed
    1. Takigawa M, Duchateau J, Sacher F, Martin R, Vlachos K, Kitamura T, et al. Are wall thickness channels defined by computed tomography predictive of isthmuses of postinfarction ventricular tachycardia? Heart Rhythm. 2019;16(11):1661–8. https://doi.org/10.1016/j.hrthm.2019.06.012 . - DOI - PubMed
    1. Jacobson AF, Senior R, Cerqueira MD, Wong ND, Thomas GS, Lopez VA, et al. Myocardial iodine-123 meta-iodobenzylguanidine imaging and cardiac events in heart failure. Results of the prospective ADMIRE-HF (AdreView Myocardial Imaging for Risk Evaluation in Heart Failure) study. J Am Coll Cardiol. 2010;55(20):2212–21. https://doi.org/10.1016/j.jacc.2010.01.014 .
    1. Fallavollita JA, Heavey BM, Luisi AJ Jr, Michalek SM, Baldwa S, Mashtare TL Jr, et al. Regional myocardial sympathetic denervation predicts the risk of sudden cardiac arrest in ischemic cardiomyopathy. J Am Coll Cardiol. 2014;63(2):141–9. https://doi.org/10.1016/j.jacc.2013.07.096 . - DOI - PubMed
    1. Blankstein R, Osborne M, Naya M, Waller A, Kim CK, Murthy VL, et al. Cardiac positron emission tomography enhances prognostic assessments of patients with suspected cardiac sarcoidosis. J Am Coll Cardiol. 2014;63(4):329–36. https://doi.org/10.1016/j.jacc.2013.09.022 . - DOI - PubMed

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