CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Dilated Left Ventricular Cardiomyopathy: a sub-study from the DERIVATE Registry

Isabella Leo; Santo Dellegrottaglie; Alessandra Scatteia; Daniele Torella; Raffaele Abete; Giovanni Donato Aquaro; Andrea Baggiano; Andrea Barison; Jan Bogaert; Leonardo Calo'; Giovanni Camastra; Samuela Carigi; Nazario Carrabba; Grazia Casavecchia; Stefano Censi; Gloria Cicala; Carlo N De Cecco; Manuel De Lazzari; Gabriella Di Giovine; Monica Dobrovie; Marta Focardi; Laura Fusini; Nicola Gaibazzi; Annalaura Gismondi; Matteo Gravina; Marco Guglielmo; Chiara Lanzillo; Massimo Lombardi; Valentina Lorenzoni; Jordi Lozano-Torres; Davide Margonato; Chiara Martini; Francesca Marzo; Pier-Giorgio Masci; Ambra Masi; Claudio Moro; Giuseppe Muscogiuri; Saima Mushtaq; Alberto Nese; Alessandro Palumbo; Anna Giulia Pavon; Patrizia Pedrotti; Martina Perazzolo Marra; Silvia Pradella; Cristina Presicci; Mark G Rabbat; Claudia Raineri; Jose' F Rodriguez-Palomares; Stefano Sbarbati; U Joseph Schoepf; Angelo Squeri; Nicola Sverzellati; Rolf Symons; Emily Tat; Mauro Timpani; Giancarlo Todiere; Adele Valentini; Akos Varga-Szemes; Alessandra Volpe; Andrea Igoren Guaricci; Juerg Schwitter; Gianluca Pontone

doi:10.1093/ehjci/jeaf043

CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Dilated Left Ventricular Cardiomyopathy: a sub-study from the DERIVATE Registry

Isabella Leo, Santo Dellegrottaglie, Alessandra Scatteia, Daniele Torella, Raffaele Abete, Giovanni Donato Aquaro, Andrea Baggiano, Andrea Barison, Jan Bogaert, Leonardo Calo', Giovanni Camastra, Samuela Carigi, Nazario Carrabba, Grazia Casavecchia, Stefano Censi, Gloria Cicala, Carlo N De Cecco, Manuel De Lazzari, Gabriella Di Giovine, Monica DobrovieMarta Focardi, Laura Fusini, Nicola Gaibazzi, Annalaura Gismondi, Matteo Gravina, Marco Guglielmo, Chiara Lanzillo, Massimo Lombardi, Valentina Lorenzoni, Jordi Lozano-Torres, Davide Margonato, Chiara Martini, Francesca Marzo, Pier-Giorgio Masci, Ambra Masi, Claudio Moro, Giuseppe Muscogiuri, Saima Mushtaq, Alberto Nese, Alessandro Palumbo, Anna Giulia Pavon, Patrizia Pedrotti, Martina Perazzolo Marra, Silvia Pradella, Cristina Presicci, Mark G Rabbat, Claudia Raineri, Jose' F Rodriguez-Palomares, Stefano Sbarbati, U Joseph Schoepf, Angelo Squeri, Nicola Sverzellati, Rolf Symons, Emily Tat, Mauro Timpani, Giancarlo Todiere, Adele Valentini, Akos Varga-Szemes, Alessandra Volpe, Andrea Igoren Guaricci, Juerg Schwitter, Gianluca Pontone

Imaging and Biomedical Engineering

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Accurate risk stratification for patients with non-dilated left ventricular cardiomyopathy (NDLVC) remains challenging due to lack of dedicated clinical trials. This post-hoc analysis aims to delineate the arrhythmic risk and assess the incremental value of cardiac magnetic resonance (CMR) imaging in the DERIVATE (CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy) study cohort meeting the NDLVC diagnostic criteria.

METHODS: Patients with NDLVC from DERIVATE registry were identified in the absence of left ventricular (LV) dilatation and in the presence of non-ischaemic LV scarring ("fibrotic NDLVC") or isolated LV systolic dysfunction (LV ejection fraction <50%) without fibrosis ("hypokinetic NDLVC"). The primary endpoint was all-cause mortality. Major adverse arrhythmic cardiac events (MAACE) were the secondary endpoint and included sudden cardiac death (SCD) and aborted SCD.

RESULTS: One hundred ninety-seven NDLVC patients were identified from the cohort of the DERIVATE study (Mean age: 59±14 years; Male: 135). Over a median follow-up of 2.7 years, 15 (8%) patients died, and 8 (4%) experienced MAACE. Patients with "hypokinetic" NDLVC had significantly lower rates of MAACE than non-ischaemic dilated cardiomyopathy (NIDCM) (p=0.001), while patients with "fibrotic" NDLVC had same rate of both primary (p=0.48) and secondary endpoints (p= 0.616) compared to NIDMC patients. Multivariable analysis identified LGE with midwall distribution as an independent predictor of MAACE in NDLVC patients (Hazard Ratio 6.7, 95% Confidence Interval: 1.33-33.67; p=0.021).

CONCLUSIONS: NDLVC patients exhibit a heterogeneous risk profile for arrhythmic events. The presence of midwall LGE, similarly to NIDCM, is a significant predictor of MAACE, highlighting the importance of CMR imaging for risk stratification.

Original language	English
Journal	European heart journal. Cardiovascular Imaging
DOIs	https://doi.org/10.1093/ehjci/jeaf043
Publication status	E-pub ahead of print - 3 Feb 2025

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10.1093/ehjci/jeaf043

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Leo, I., Dellegrottaglie, S., Scatteia, A., Torella, D., Abete, R., Aquaro, G. D., Baggiano, A., Barison, A., Bogaert, J., Calo', L., Camastra, G., Carigi, S., Carrabba, N., Casavecchia, G., Censi, S., Cicala, G., De Cecco, C. N., De Lazzari, M., Di Giovine, G., ... Pontone, G. (2025). CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Dilated Left Ventricular Cardiomyopathy: a sub-study from the DERIVATE Registry. European heart journal. Cardiovascular Imaging. Advance online publication. https://doi.org/10.1093/ehjci/jeaf043

@article{089ac8bf20c94c85acfd13ad9a745fb1,

title = "CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Dilated Left Ventricular Cardiomyopathy: a sub-study from the DERIVATE Registry",

abstract = "BACKGROUND: Accurate risk stratification for patients with non-dilated left ventricular cardiomyopathy (NDLVC) remains challenging due to lack of dedicated clinical trials. This post-hoc analysis aims to delineate the arrhythmic risk and assess the incremental value of cardiac magnetic resonance (CMR) imaging in the DERIVATE (CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy) study cohort meeting the NDLVC diagnostic criteria.METHODS: Patients with NDLVC from DERIVATE registry were identified in the absence of left ventricular (LV) dilatation and in the presence of non-ischaemic LV scarring ({"}fibrotic NDLVC{"}) or isolated LV systolic dysfunction (LV ejection fraction <50%) without fibrosis ({"}hypokinetic NDLVC{"}). The primary endpoint was all-cause mortality. Major adverse arrhythmic cardiac events (MAACE) were the secondary endpoint and included sudden cardiac death (SCD) and aborted SCD.RESULTS: One hundred ninety-seven NDLVC patients were identified from the cohort of the DERIVATE study (Mean age: 59±14 years; Male: 135). Over a median follow-up of 2.7 years, 15 (8%) patients died, and 8 (4%) experienced MAACE. Patients with {"}hypokinetic{"} NDLVC had significantly lower rates of MAACE than non-ischaemic dilated cardiomyopathy (NIDCM) (p=0.001), while patients with {"}fibrotic{"} NDLVC had same rate of both primary (p=0.48) and secondary endpoints (p= 0.616) compared to NIDMC patients. Multivariable analysis identified LGE with midwall distribution as an independent predictor of MAACE in NDLVC patients (Hazard Ratio 6.7, 95% Confidence Interval: 1.33-33.67; p=0.021).CONCLUSIONS: NDLVC patients exhibit a heterogeneous risk profile for arrhythmic events. The presence of midwall LGE, similarly to NIDCM, is a significant predictor of MAACE, highlighting the importance of CMR imaging for risk stratification.",

author = "Isabella Leo and Santo Dellegrottaglie and Alessandra Scatteia and Daniele Torella and Raffaele Abete and Aquaro, {Giovanni Donato} and Andrea Baggiano and Andrea Barison and Jan Bogaert and Leonardo Calo' and Giovanni Camastra and Samuela Carigi and Nazario Carrabba and Grazia Casavecchia and Stefano Censi and Gloria Cicala and {De Cecco}, {Carlo N} and {De Lazzari}, Manuel and {Di Giovine}, Gabriella and Monica Dobrovie and Marta Focardi and Laura Fusini and Nicola Gaibazzi and Annalaura Gismondi and Matteo Gravina and Marco Guglielmo and Chiara Lanzillo and Massimo Lombardi and Valentina Lorenzoni and Jordi Lozano-Torres and Davide Margonato and Chiara Martini and Francesca Marzo and Pier-Giorgio Masci and Ambra Masi and Claudio Moro and Giuseppe Muscogiuri and Saima Mushtaq and Alberto Nese and Alessandro Palumbo and Pavon, {Anna Giulia} and Patrizia Pedrotti and {Perazzolo Marra}, Martina and Silvia Pradella and Cristina Presicci and Rabbat, {Mark G} and Claudia Raineri and Rodriguez-Palomares, {Jose' F} and Stefano Sbarbati and Schoepf, {U Joseph} and Angelo Squeri and Nicola Sverzellati and Rolf Symons and Emily Tat and Mauro Timpani and Giancarlo Todiere and Adele Valentini and Akos Varga-Szemes and Alessandra Volpe and Guaricci, {Andrea Igoren} and Juerg Schwitter and Gianluca Pontone",

note = "{\textcopyright} The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology.",

year = "2025",

month = feb,

day = "3",

doi = "10.1093/ehjci/jeaf043",

language = "English",

journal = "European heart journal. Cardiovascular Imaging",

issn = "2047-2404",

publisher = "Oxford University Press",

}

Leo, I, Dellegrottaglie, S, Scatteia, A, Torella, D, Abete, R, Aquaro, GD, Baggiano, A, Barison, A, Bogaert, J, Calo', L, Camastra, G, Carigi, S, Carrabba, N, Casavecchia, G, Censi, S, Cicala, G, De Cecco, CN, De Lazzari, M, Di Giovine, G, Dobrovie, M, Focardi, M, Fusini, L, Gaibazzi, N, Gismondi, A, Gravina, M, Guglielmo, M, Lanzillo, C, Lombardi, M, Lorenzoni, V, Lozano-Torres, J, Margonato, D, Martini, C, Marzo, F, Masci, P-G, Masi, A, Moro, C, Muscogiuri, G, Mushtaq, S, Nese, A, Palumbo, A, Pavon, AG, Pedrotti, P, Perazzolo Marra, M, Pradella, S, Presicci, C, Rabbat, MG, Raineri, C, Rodriguez-Palomares, JF, Sbarbati, S, Schoepf, UJ, Squeri, A, Sverzellati, N, Symons, R, Tat, E, Timpani, M, Todiere, G, Valentini, A, Varga-Szemes, A, Volpe, A, Guaricci, AI, Schwitter, J & Pontone, G 2025, 'CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Dilated Left Ventricular Cardiomyopathy: a sub-study from the DERIVATE Registry', European heart journal. Cardiovascular Imaging. https://doi.org/10.1093/ehjci/jeaf043

CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Dilated Left Ventricular Cardiomyopathy: a sub-study from the DERIVATE Registry. / Leo, Isabella; Dellegrottaglie, Santo; Scatteia, Alessandra et al.
In: European heart journal. Cardiovascular Imaging, 03.02.2025.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Dilated Left Ventricular Cardiomyopathy

T2 - a sub-study from the DERIVATE Registry

AU - Leo, Isabella

AU - Dellegrottaglie, Santo

AU - Scatteia, Alessandra

AU - Torella, Daniele

AU - Abete, Raffaele

AU - Aquaro, Giovanni Donato

AU - Baggiano, Andrea

AU - Barison, Andrea

AU - Bogaert, Jan

AU - Calo', Leonardo

AU - Camastra, Giovanni

AU - Carigi, Samuela

AU - Carrabba, Nazario

AU - Casavecchia, Grazia

AU - Censi, Stefano

AU - Cicala, Gloria

AU - De Cecco, Carlo N

AU - De Lazzari, Manuel

AU - Di Giovine, Gabriella

AU - Dobrovie, Monica

AU - Focardi, Marta

AU - Fusini, Laura

AU - Gaibazzi, Nicola

AU - Gismondi, Annalaura

AU - Gravina, Matteo

AU - Guglielmo, Marco

AU - Lanzillo, Chiara

AU - Lombardi, Massimo

AU - Lorenzoni, Valentina

AU - Lozano-Torres, Jordi

AU - Margonato, Davide

AU - Martini, Chiara

AU - Marzo, Francesca

AU - Masci, Pier-Giorgio

AU - Masi, Ambra

AU - Moro, Claudio

AU - Muscogiuri, Giuseppe

AU - Mushtaq, Saima

AU - Nese, Alberto

AU - Palumbo, Alessandro

AU - Pavon, Anna Giulia

AU - Pedrotti, Patrizia

AU - Perazzolo Marra, Martina

AU - Pradella, Silvia

AU - Presicci, Cristina

AU - Rabbat, Mark G

AU - Raineri, Claudia

AU - Rodriguez-Palomares, Jose' F

AU - Sbarbati, Stefano

AU - Schoepf, U Joseph

AU - Squeri, Angelo

AU - Sverzellati, Nicola

AU - Symons, Rolf

AU - Tat, Emily

AU - Timpani, Mauro

AU - Todiere, Giancarlo

AU - Valentini, Adele

AU - Varga-Szemes, Akos

AU - Volpe, Alessandra

AU - Guaricci, Andrea Igoren

AU - Schwitter, Juerg

AU - Pontone, Gianluca

PY - 2025/2/3

Y1 - 2025/2/3

N2 - BACKGROUND: Accurate risk stratification for patients with non-dilated left ventricular cardiomyopathy (NDLVC) remains challenging due to lack of dedicated clinical trials. This post-hoc analysis aims to delineate the arrhythmic risk and assess the incremental value of cardiac magnetic resonance (CMR) imaging in the DERIVATE (CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy) study cohort meeting the NDLVC diagnostic criteria.METHODS: Patients with NDLVC from DERIVATE registry were identified in the absence of left ventricular (LV) dilatation and in the presence of non-ischaemic LV scarring ("fibrotic NDLVC") or isolated LV systolic dysfunction (LV ejection fraction <50%) without fibrosis ("hypokinetic NDLVC"). The primary endpoint was all-cause mortality. Major adverse arrhythmic cardiac events (MAACE) were the secondary endpoint and included sudden cardiac death (SCD) and aborted SCD.RESULTS: One hundred ninety-seven NDLVC patients were identified from the cohort of the DERIVATE study (Mean age: 59±14 years; Male: 135). Over a median follow-up of 2.7 years, 15 (8%) patients died, and 8 (4%) experienced MAACE. Patients with "hypokinetic" NDLVC had significantly lower rates of MAACE than non-ischaemic dilated cardiomyopathy (NIDCM) (p=0.001), while patients with "fibrotic" NDLVC had same rate of both primary (p=0.48) and secondary endpoints (p= 0.616) compared to NIDMC patients. Multivariable analysis identified LGE with midwall distribution as an independent predictor of MAACE in NDLVC patients (Hazard Ratio 6.7, 95% Confidence Interval: 1.33-33.67; p=0.021).CONCLUSIONS: NDLVC patients exhibit a heterogeneous risk profile for arrhythmic events. The presence of midwall LGE, similarly to NIDCM, is a significant predictor of MAACE, highlighting the importance of CMR imaging for risk stratification.

AB - BACKGROUND: Accurate risk stratification for patients with non-dilated left ventricular cardiomyopathy (NDLVC) remains challenging due to lack of dedicated clinical trials. This post-hoc analysis aims to delineate the arrhythmic risk and assess the incremental value of cardiac magnetic resonance (CMR) imaging in the DERIVATE (CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy) study cohort meeting the NDLVC diagnostic criteria.METHODS: Patients with NDLVC from DERIVATE registry were identified in the absence of left ventricular (LV) dilatation and in the presence of non-ischaemic LV scarring ("fibrotic NDLVC") or isolated LV systolic dysfunction (LV ejection fraction <50%) without fibrosis ("hypokinetic NDLVC"). The primary endpoint was all-cause mortality. Major adverse arrhythmic cardiac events (MAACE) were the secondary endpoint and included sudden cardiac death (SCD) and aborted SCD.RESULTS: One hundred ninety-seven NDLVC patients were identified from the cohort of the DERIVATE study (Mean age: 59±14 years; Male: 135). Over a median follow-up of 2.7 years, 15 (8%) patients died, and 8 (4%) experienced MAACE. Patients with "hypokinetic" NDLVC had significantly lower rates of MAACE than non-ischaemic dilated cardiomyopathy (NIDCM) (p=0.001), while patients with "fibrotic" NDLVC had same rate of both primary (p=0.48) and secondary endpoints (p= 0.616) compared to NIDMC patients. Multivariable analysis identified LGE with midwall distribution as an independent predictor of MAACE in NDLVC patients (Hazard Ratio 6.7, 95% Confidence Interval: 1.33-33.67; p=0.021).CONCLUSIONS: NDLVC patients exhibit a heterogeneous risk profile for arrhythmic events. The presence of midwall LGE, similarly to NIDCM, is a significant predictor of MAACE, highlighting the importance of CMR imaging for risk stratification.

U2 - 10.1093/ehjci/jeaf043

DO - 10.1093/ehjci/jeaf043

M3 - Article

C2 - 39899463

SN - 2047-2404

JO - European heart journal. Cardiovascular Imaging

JF - European heart journal. Cardiovascular Imaging

ER -

CarDiac magnEtic Resonance for prophylactic Implantable-cardioVerter defibrillAtor ThErapy in Non-Dilated Left Ventricular Cardiomyopathy: a sub-study from the DERIVATE Registry

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