Special Issue "Sudden Cardiac Death: Role of Multimodality Imaging in Risk Stratification"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: closed (15 July 2022) | Viewed by 1326

Special Issue Editors

Dr. Marco Guglielmo
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Guest Editor
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
Interests: clinical cardiology; transthoracic and transesophageal echocardiography; cardiac MRI; cardiac CT; multimodality assessment of coronary artery disease and valvulopathies
Dr. Anna Giulia Pavon
E-Mail
Guest Editor
Department Cardiology, lIstituto Cardiocentro Ticino, Lugano, Switzerland
Interests: cardiovascular imaging; cardiovascular magnetic resonance; 2D and 3D echocardiography; valvular heart disease; arrhythmic mitral valve prolapse

Special Issue Information

Dear Colleagues,

Sudden cardiac death (SCD) is the most common cause of cardiovascular death averaging 300–400,000 deaths in the United States annually. From a pathophysiological point of view, SCD is the result of a predisposing substrate upon which a trigger acts, resulting in a lethal ventricular arrhythmia. In the broad spectrum of cardiovascular disease which can cause SCD (including cardiomyopathies, myocarditis, valvulopathies, and primary electrical disorders) the most common underlying cause of SCD is myocardial infarction related scar leading to ventricular tachyarrhythmia. implantable cardioverter-defibrillator represents the mainstay therapy for primary and secondary prevention of SCD. Left ventricular ejection fraction (LVEF) remains the main criterion for selecting patients for ICD implantation as primary prevention. However, multimodality cardiac imaging including echocardiography, cardiac magnetic resonance, cardiac CT, PET and SPECT, have shown superiority to LVEF in risk stratifying patients for SCD. This special issue aims to review the last technical advances in the field of cardiovascular imaging to improve patient’s risk assessment for SCD and to discuss the challenges that the cardiovascular imager may face.

Dr. Marco Guglielmo
Dr. Anna Giulia Pavon
Guest Editors

Manuscript Submission Information

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Keywords

  • Sudden Cardiac Death
  • Multimodality Imaging
  • Risk assessment
  • Echocardiography
  • Cardiac Magnetic Resonance, Cardiac CT, PET, SPECT

Published Papers (2 papers)

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Review

Review
State-of-the-Art Multimodality Imaging in Sudden Cardiac Arrest with Focus on Idiopathic Ventricular Fibrillation: A Review
J. Clin. Med. 2022, 11(16), 4680; https://doi.org/10.3390/jcm11164680 - 10 Aug 2022
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Abstract
Idiopathic ventricular fibrillation is a rare cause of sudden cardiac arrest and a diagnosis by exclusion. Unraveling the mechanism of ventricular fibrillation is important for targeted management, and potentially for initiating family screening. Sudden cardiac arrest survivors undergo extensive clinical testing, with a [...] Read more.
Idiopathic ventricular fibrillation is a rare cause of sudden cardiac arrest and a diagnosis by exclusion. Unraveling the mechanism of ventricular fibrillation is important for targeted management, and potentially for initiating family screening. Sudden cardiac arrest survivors undergo extensive clinical testing, with a growing role for multimodality imaging, before diagnosing “idiopathic” ventricular fibrillation. Multimodality imaging, considered as using multiple imaging modalities as diagnostics, is important for revealing structural myocardial abnormalities in patients with cardiac arrest. This review focuses on combining imaging modalities (echocardiography, cardiac magnetic resonance and computed tomography) and the electrocardiographic characterization of sudden cardiac arrest survivors and discusses the surplus value of multimodality imaging in the diagnostic routing of these patients. We focus on novel insights obtained through electrostructural and/or electromechanical imaging in apparently idiopathic ventricular fibrillation patients, with special attention to non-invasive electrocardiographic imaging. Full article
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Review
Multi-Modality Imaging for Prevention of Coronary Artery Disease and Myocardial Infarction in the General Population: Ready for Prime Time?
J. Clin. Med. 2022, 11(11), 2965; https://doi.org/10.3390/jcm11112965 - 24 May 2022
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Abstract
Cardiovascular disease (CVD) remains a leading cause of death and disability worldwide. Acute myocardial infarction (AMI) causes irreversible myocardial damage, heart failure, life-threatening arrythmias and sudden cardiac death (SCD), and is a main driver of CVD mortality and morbidity. To control the forecasted [...] Read more.
Cardiovascular disease (CVD) remains a leading cause of death and disability worldwide. Acute myocardial infarction (AMI) causes irreversible myocardial damage, heart failure, life-threatening arrythmias and sudden cardiac death (SCD), and is a main driver of CVD mortality and morbidity. To control the forecasted increase in CVD burden for both the individual and society, improved strategies for the prevention of AMI and SCD are required. Current prevention of AMI and SCD is directed towards risk-modifying interventions, guided by risk assessment using clinical risk prediction scores (CRPSs) and the coronary artery calcium score (CACS). Early detection of more advanced coronary artery disease (CAD), beyond risk assessment by CRPSs or CACS, is a promising strategy to allow personalized treatment for the improved prevention of AMI and SCD in the general population. We review evidence for further testing, beyond CRPSs and CACS, and therapies focusing on promising targets, including subclinical obstructive CAD, high-risk plaques, and silent myocardial ischemia. We also evaluate the potential of multi-modality imaging to enhance the conduction of adequately powered trials to provide high-quality evidence on the impact of add-on tests and therapies in the prevention of AMI and SCD in asymptomatic individuals. To conclude, we discuss the occurrence of AMI and SCD in individuals currently estimated to be at “low-risk” by the current strategy based on CRPSs, and methods to improve prevention of AMI and SCD in this “low-risk” population. Full article
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