@article{16355,
  author = {Gabriel Balaban and Brian Halliday and Daniel Hammersley and Christopher Rinaldi and Sanjay Prasad and Martin Bishop and Pablo Lamata},
  title = {Left ventricular shape predicts arrhythmic risk in fibrotic dilated cardiomyopathy},
  abstract = {Aims: Remodelling of the left ventricular (LV) shape is one of the hallmarks of non-ischaemic dilated cardiomyopathy (DCM) and may contribute to ventricular arrhythmias and sudden cardiac death. We sought to investigate a novel three dimensional (3D) shape analysis approach to quantify LV remodelling for arrhythmia prediction in DCM....................................................................................................................................................................................................Methods and resultsWe created 3D LV shape models from end-diastolic cardiac magnetic resonance images of 156 patients with DCM and late gadolinium enhancement (LGE). Using the shape models, principle component analysis, and Cox-Lasso re-gression, we derived a prognostic LV arrhythmic shape (LVAS) score which identified patients who reached a com-posite arrhythmic endpoint of sudden cardiac death, aborted sudden cardiac death, and sustained ventricular tachy-cardia. We also extracted geometrical metrics to look for potential prognostic markers. During a follow-up period of up to 16 years (median 7.7, interquartile range: 3.9), 25 patients met the arrhythmic endpoint. The optimally prognostic LV shape for predicting the time-to arrhythmic event was a paraboloidal longitudinal profile, with a relatively wide base. The corresponding LVAS was associated with arrhythmic events in univariate Cox regression (hazard ratio = 2.0 per quartile; 95\% confidence interval: 1.3{\textendash}2.9), in univariate Cox regression with propensity score adjustment, and in three multivariate models; with LV ejection fraction, New York Heart Association Class III/IV (Model 1), implantable cardioverter-defibrillator receipt (Model 2), and cardiac resynchronization therapy (Model 3)....................................................................................................................................................................................................ConclusionBiomarkers of LV shape remodelling in DCM can help to identify the patients at greatest risk of lethal ventricular arrhythmias.},
  year = {2021},
  journal = {EP Europace},
  pages = {1-11},
  month = {12/2021},
  publisher = {European Society of Cardiology},
}