Left Ventricular Late Gadolinium Enhancement for Arrhythmic Risk Prediction in ARVC
(2026) In Circulation: Arrhythmia and Electrophysiology Publish Ahead of Print.- Abstract
BACKGROUND: – The arrhythmogenic right ventricular cardiomyopathy (ARVC) risk calculator estimates the risk of incident sustained ventricular arrhythmia (VA) and performs well in ARVC populations meeting 2010 Task Force Criteria. However, the calculator includes no measure of left ventricular (LV) structure and function, while late gadolinium enhancement (LGE) on cardiac magnetic resonance shows promise in arrhythmic risk prediction. This study aims to evaluate whether LV LGE on cardiac magnetic resonance can further refine ARVC VA risk stratification. METHODS: – Patients with definite ARVC, no prior sustained VA, and contrast-enhanced cardiac magnetic resonance at baseline were followed at 17 centers. Survival analyses were performed... (More)
BACKGROUND: – The arrhythmogenic right ventricular cardiomyopathy (ARVC) risk calculator estimates the risk of incident sustained ventricular arrhythmia (VA) and performs well in ARVC populations meeting 2010 Task Force Criteria. However, the calculator includes no measure of left ventricular (LV) structure and function, while late gadolinium enhancement (LGE) on cardiac magnetic resonance shows promise in arrhythmic risk prediction. This study aims to evaluate whether LV LGE on cardiac magnetic resonance can further refine ARVC VA risk stratification. METHODS: – Patients with definite ARVC, no prior sustained VA, and contrast-enhanced cardiac magnetic resonance at baseline were followed at 17 centers. Survival analyses were performed to assess LV LGE effect on VA prediction, and its incremental prognostic value on the risk calculator was evaluated using Cox proportional hazard models. The presence of high-risk LGE, defined as LV epicardial, transmural, and combined septal and free-wall LGE, was studied as a sensitivity analysis. RESULTS: – Of 385 patients (39.6±15.4 years, 39.7% male, 54.0% probands), 132 (34.3%) had LV LGE on cardiac magnetic resonance, with 98 (25.5%) having a high-risk pattern. Over 3.1 [1.2–5.8] years of follow-up, 67 (17.4%) patients experienced VA. In univariable analysis, both LV LGE (hazard ratio, 1.82; P=0.014) and high-risk LV LGE (hazard ratio, 1.85; P=0.017) were associated with higher risk for VA. However, after adjusting for the ARVC calculator–estimated risk, the presence of neither LV LGE (P=0.85) nor high-risk LV LGE (P=0.87) independently predicted sustained VA. CONCLUSIONS: – While associated with the risk of VA in ARVC, LV LGE did not provide incremental prognostic value for incident VA risk prediction compared with the ARVC risk calculator.
(Less)
- author
- organization
- publishing date
- 2026-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- arrhythmias, cardiac, death, sudden, cardiac, heart ventricles, prognosis, risk assessment
- in
- Circulation: Arrhythmia and Electrophysiology
- volume
- Publish Ahead of Print
- article number
- e014265
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- scopus:105030079275
- pmid:41608798
- ISSN
- 1941-3149
- DOI
- 10.1161/CIRCEP.125.014265
- language
- English
- LU publication?
- yes
- id
- c5620ec9-c7f8-4f0c-bd4f-1c941e6bd45f
- date added to LUP
- 2026-03-02 11:19:43
- date last changed
- 2026-09-02 14:01:36
@article{c5620ec9-c7f8-4f0c-bd4f-1c941e6bd45f,
abstract = {{<p>BACKGROUND: – The arrhythmogenic right ventricular cardiomyopathy (ARVC) risk calculator estimates the risk of incident sustained ventricular arrhythmia (VA) and performs well in ARVC populations meeting 2010 Task Force Criteria. However, the calculator includes no measure of left ventricular (LV) structure and function, while late gadolinium enhancement (LGE) on cardiac magnetic resonance shows promise in arrhythmic risk prediction. This study aims to evaluate whether LV LGE on cardiac magnetic resonance can further refine ARVC VA risk stratification. METHODS: – Patients with definite ARVC, no prior sustained VA, and contrast-enhanced cardiac magnetic resonance at baseline were followed at 17 centers. Survival analyses were performed to assess LV LGE effect on VA prediction, and its incremental prognostic value on the risk calculator was evaluated using Cox proportional hazard models. The presence of high-risk LGE, defined as LV epicardial, transmural, and combined septal and free-wall LGE, was studied as a sensitivity analysis. RESULTS: – Of 385 patients (39.6±15.4 years, 39.7% male, 54.0% probands), 132 (34.3%) had LV LGE on cardiac magnetic resonance, with 98 (25.5%) having a high-risk pattern. Over 3.1 [1.2–5.8] years of follow-up, 67 (17.4%) patients experienced VA. In univariable analysis, both LV LGE (hazard ratio, 1.82; P=0.014) and high-risk LV LGE (hazard ratio, 1.85; P=0.017) were associated with higher risk for VA. However, after adjusting for the ARVC calculator–estimated risk, the presence of neither LV LGE (P=0.85) nor high-risk LV LGE (P=0.87) independently predicted sustained VA. CONCLUSIONS: – While associated with the risk of VA in ARVC, LV LGE did not provide incremental prognostic value for incident VA risk prediction compared with the ARVC risk calculator.</p>}},
author = {{De Marco, Corrado and Asatryan, Babken and te Riele, Anneline S.J.M. and Di Marco, Andrea and Gasperetti, Alessio and Delinière, Antoine and Roberts, Jason D. and Jensen, Henrik K. and Davies, Brianna and Krahn, Andrew D. and Tadros, Rafik and Svensson, Anneli and Castelletti, Silvia and Crotti, Lia and Platonov, Pyotr G. and Borowiec, Karolina and Biernacka, Elżbieta K. and Arbelo, Elena and David, Louis Philippe and Saguner, Ardan M. and Healey, Jeff S. and Brunckhorst, Corinna and Cappelletto, Chiara and Stolfo, Davide and Merlo, Marco and Rootwelt-Norberg, Christine and Haugaa, Kristina and Duru, Firat and van Tintelen, J. Peter and Velthuis, Birgitta K. and Calkins, Hugh and Zimmerman, Stefan L. and James, Cynthia A. and Bosman, Laurens P. and Cadrin-Tourigny, Julia}},
issn = {{1941-3149}},
keywords = {{arrhythmias, cardiac; death, sudden, cardiac; heart ventricles; prognosis; risk assessment}},
language = {{eng}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Circulation: Arrhythmia and Electrophysiology}},
title = {{Left Ventricular Late Gadolinium Enhancement for Arrhythmic Risk Prediction in ARVC}},
url = {{http://dx.doi.org/10.1161/CIRCEP.125.014265}},
doi = {{10.1161/CIRCEP.125.014265}},
volume = {{Publish Ahead of Print}},
year = {{2026}},
}