PO-05-061 RIGHT VENTRICULAR SYSTOLIC FUNCTION ON MRI IS RELATED TO APPROPRIATE ICD THERAPY

Abstract

Right ventricular function is recently referred as an independent predictor of sudden cardiac death (SCD). The purpose of this study was to evaluate the association of right ventricular ejection fraction (RVEF) on magnetic resonance imaging (MRI) and appropriate ICD therapy. Consecutive patients who underwent initial ICD implantation for any diseases except for non-dilated phase hypertrophic cardiomyopathy and channelopathy were retrospectively enrolled from 2012 to 2018 and were followed up on appropriate ICD therapy and death. We enrolled patients who underwent MRI before ICD implantation. RVEF, RV radial strain, RV circumferential strain (RVCS), RV 4 chamber transmural strain and RV 4 chamber longitudinal stain were evaluated to investigate the association with appropriate ICD therapy. RVEF was analyzed on the software (MR Multi-Chamber Wall Motion Tracking, Canon). In total, 97 patients (58.5±14.5 years, 69 males) including 20 ischemic cardiomyopathy were enrolled. Fifty-one patients received an ICD as a secondary prophylaxis. Mean LVEF and RVEF were 37.4±14.5% and 36.2±12.6%, respectively. There was no correlation between RVEF and LVEF (correlation coefficient =0.36). Regarding appropriate ICD therapy events, the best cut-off value of RVEF was 43.0%. The hazard ratio (HR) of low RVEF was 9.601 (95%CI: 1.287-71.6, P=0.027). Secondary prophylactic cohort with low RVEF showed highest incidence of appropriate ICD therapy as shown in the figure. In multivariate analysis about RVEF and RV strain, low RVEF and RVCS were independent predictors of appropriate ICD therapy (RVEF:HR 12.4, 95%CI:1.51-101, P=0.019 and circumferential strain: HR 0.8, 95%CI:0.76-0.98, P=0.021). RVCS in appropriate ICD group (-11.1±4.6%) was lower than RVCS in non-therapy group (-7.0±11.7%). Low RVCS predicted higher incidence of appropriate ICD therapy. Low RVEF was associated with increased appropriate ICD therapy.