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Current Cardiology Reviews 2023Mitral valve prolapse (MVP) is the most frequent valvulopathy in the general population, with usually a favourable prognosis. Although it can be associated with some...
Mitral valve prolapse (MVP) is the most frequent valvulopathy in the general population, with usually a favourable prognosis. Although it can be associated with some complications, ventricular arrhythmias (VA) and sudden cardiac death (SCD) are the most worrying. The estimated risk of SCD in MVP is between 0.2% to 1.9% per year, including MVP patients with and without severe mitral regurgitation (MR). The association between SCD and MVP is expressed by a phenotype called "malignant MVP" characterized by transthoracic echocardiography (TTE) findings such as bileaflet myxomatous prolapse and mitral annulus disjunction (MAD), ECG findings such as repolarization abnormalities, complex ventricular arrhythmias (c-VAs) and LV fibrosis of papillary muscles (PMs) and inferobasal wall visualized by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Therefore, attention is raised for patients with "arrhythmic MVP" characterized from an ECG point of view by frequent premature ventricular contractions (PVCs) arising from one or both PMs as well as by T-wave inversion in the inferolateral leads. In athletes, SCD is the most frequent medical cause of death and in young subjects (< 35 years) usually is due to electrical mechanism affecting who has a silent cardiovascular disease and are not considered per se a cause of increased mortality. In MVP, SCD was reported to happen during sports activity or immediately after and valve prolapse was the only pathological aspect detected. The aim of the present paper is to explore the association between SCD and MVP in athletes, focusing attention on ECG, TTE in particular, and CMR findings that could help to identify subjects at high risk for complex arrhythmias and eventually SCD. In addition, it is also examined if sports activity might predispose patients with MVP to develop major arrhythmias.
Topics: Humans; Mitral Valve Prolapse; Contrast Media; Gadolinium; Death, Sudden, Cardiac; Mitral Valve; Ventricular Premature Complexes; Prolapse; Athletes
PubMed: 36545732
DOI: 10.2174/1573403X19666221220163431 -
The Nursing Clinics of North America Dec 2013Hypertrophic cardiomyopathy (HCM) is an autosomal dominant, cardiovascular disorder that carries the risk of sudden cardiac death. The prevalence of HCM is 1:500... (Review)
Review
Hypertrophic cardiomyopathy (HCM) is an autosomal dominant, cardiovascular disorder that carries the risk of sudden cardiac death. The prevalence of HCM is 1:500 persons. The purpose of this article is to provide an overview of the pathophysiology, symptoms, complications, diagnostic testing, and treatment. The silent presentation of HCM presents unique diagnostic challenges and complicates prompt identification. Diagnostic testing and management strategies for the care of a person with HCM are discussed. HCM has individualized presentation and therefore requires individualized therapy.
Topics: Cardiomyopathy, Hypertrophic; Death, Sudden, Cardiac; Humans; Hypertrophy, Left Ventricular; Nurse's Role; Nursing Process; Practice Patterns, Nurses'; Precision Medicine; Ventricular Dysfunction, Left
PubMed: 24295188
DOI: 10.1016/j.cnur.2013.09.001 -
Circulation Research Jan 2021
Topics: Arrhythmias, Cardiac; Death, Sudden, Cardiac; Humans
PubMed: 33476206
DOI: 10.1161/CIRCRESAHA.120.318576 -
Europace : European Pacing,... Oct 2022Arrhythmogenic right ventricular cardiomyopathy (ARVC), an inherited heart muscle abnormality, is a major cause of sudden cardiac death (SCD). However, the burden of SCD... (Meta-Analysis)
Meta-Analysis
AIMS
Arrhythmogenic right ventricular cardiomyopathy (ARVC), an inherited heart muscle abnormality, is a major cause of sudden cardiac death (SCD). However, the burden of SCD and risk factors in ARVC are not clearly described. Thus, we estimated the rates and predictors of SCD in ARVC in a meta-analysis.
METHODS AND RESULTS
PubMed, Embase, and Web of Science were searched through 7 April 2021. Prospective studies reporting SCD from ARVC cohorts were included. Data were independently extracted by two reviewers and pooled in a random-effects meta-analysis. Fifty-two studies (n = 5485 patients) with moderate-to-low risk of bias were included. The pooled annualized rates of SCD were 0.65 per 1000 [95% confidence interval 0.00-6.43, I2 0.00%] in those with an implantable cardioverter-defibrillator (ICD) and 7.21 (2.38-13.79, I2 0.0%) in non-ICD cohorts: 7.14 in probands and 8.44 for 2010 Task Force Criteria (TFC). Multivariable predictors of life-threatening arrhythmic events including SCD were: age at presentation [adjusted hazard ratio 0.98 (0.97-0.99)], male sex [2.08 (1.29-3.36)], right ventricular (RV) dysfunction [6.99 (2.17-22.49)], QRS fragmentation [6.55 (3.33-12.90)], T-wave inversion [1.12 (1.02-1.24)], syncope at presentation [2.83 (2.40-4.08)], previous non-sustained ventricular tachyarrhythmia [2.53 (1.44-4.45)], and the TFC score [1.96 (1.02-3.76)], (P < 0.05). Predictors of appropriate ICD therapy were RV dysfunction, syncope, and inducible ventricular arrhythmia (P < 0.01).
CONCLUSION
This meta-analysis demonstrates a high burden of SCD in ARVC patients, especially among probands and ARVC defined by the modified TFC. Better strategies are required to improve patient management and prevent SCD in ARVC. PROSPERO ID: CRD42020211761.
Topics: Arrhythmias, Cardiac; Arrhythmogenic Right Ventricular Dysplasia; Death, Sudden, Cardiac; Defibrillators, Implantable; Humans; Incidence; Male; Prospective Studies; Risk Factors; Syncope; Ventricular Dysfunction, Right
PubMed: 35298614
DOI: 10.1093/europace/euac014 -
Herz Jun 2023Arrhythmic manifestations of COVID-19 include atrial arrhythmias such as atrial fibrillation or atrial flutter, sinus node dysfunction, atrioventricular conduction... (Review)
Review
Arrhythmic manifestations of COVID-19 include atrial arrhythmias such as atrial fibrillation or atrial flutter, sinus node dysfunction, atrioventricular conduction abnormalities, ventricular tachyarrhythmias, sudden cardiac arrest, and cardiovascular dysautonomias including the so-called long COVID syndrome. Various pathophysiological mechanisms have been implicated, such as direct viral invasion, hypoxemia, local and systemic inflammation, changes in ion channel physiology, immune activation, and autonomic dysregulation. The development of atrial or ventricular arrhythmias in hospitalized COVID-19 patients has been shown to portend a higher risk of in-hospital death. Management of these arrhythmias should be based on published evidence-based guidelines, with special consideration of the acuity of COVID-19 infection, concomitant use of antimicrobial and anti-inflammatory drugs, and the transient nature of some rhythm disorders. In view of new SARS-CoV‑2 variants that may evolve, the development and use of newer antiviral and immunomodulator drugs, and the increasing adoption of vaccination, clinicians must remain vigilant for other arrhythmic manifestations that may occur in association with this novel but potentially deadly disease.
Topics: Humans; Atrial Fibrillation; Incidence; Post-Acute COVID-19 Syndrome; Hospital Mortality; COVID-19; SARS-CoV-2; Death, Sudden, Cardiac
PubMed: 37277617
DOI: 10.1007/s00059-023-05186-2 -
Gene Feb 2022Sudden death is one of the major causes of death in young adults. Sudden death could be a result from both genetic and environmental or acquired factors. Understanding... (Review)
Review
Sudden death is one of the major causes of death in young adults. Sudden death could be a result from both genetic and environmental or acquired factors. Understanding the genetic etiology is crucial to prevent preventable sudden death for those who are not aware of their genetic condition. In fact, the spectrum of causes of sudden death is complex and varied. In this study, we reviewed the genes that are associated with multiple causes of sudden death in terms of both sudden cardiac death and sudden noncardiac death. A summary of genetic risk factors of the major causes of genetic relevant sudden death is also provided. We believe this review could benefit the researchers who are interested in sudden death genetic studies or the young people who are concerning about their own risk on sudden death.
Topics: Adult; Death, Sudden; Death, Sudden, Cardiac; High-Throughput Nucleotide Sequencing; Humans; Young Adult
PubMed: 34843881
DOI: 10.1016/j.gene.2021.146067 -
JACC. Heart Failure Jun 2014
Topics: Atrial Fibrillation; Death, Sudden, Cardiac; Female; Heart Failure; Humans; Male
PubMed: 24952688
DOI: 10.1016/j.jchf.2014.03.004 -
Methodist DeBakey Cardiovascular Journal 2016There are clear health benefits to exercise; even so, patients with cardiac conditions who engage in exercise and athletic competition may on rare occasion experience... (Review)
Review
There are clear health benefits to exercise; even so, patients with cardiac conditions who engage in exercise and athletic competition may on rare occasion experience sudden cardiac death (SCD). This article reviews the epidemiology and common causes of SCD in specific athlete populations. There is ongoing debate about the optimal mechanism for SCD prevention, specifically regarding the inclusion of the ECG and/or cardiac imaging in routine preparticipation sports evaluation. This controversy and contemporary screening recommendations are also reviewed.
Topics: Athletes; Death, Sudden, Cardiac; Electrocardiography; Exercise Tolerance; Global Health; Humans; Incidence; Risk Assessment; Risk Factors
PubMed: 27486488
DOI: 10.14797/mdcj-12-2-76 -
Journal of the American College of... Mar 2023Causes and precipitating factors of sudden cardiac death (SCD) in adolescents are poorly understood.
BACKGROUND
Causes and precipitating factors of sudden cardiac death (SCD) in adolescents are poorly understood.
OBJECTIVES
The authors sought to investigate the etiologies of SCD and their association with physical activity in a large cohort of adolescents.
METHODS
Between 1994 and June 2022, 7,675 cases of SCD were consecutively referred to our national cardiac pathology center; 756 (10%) were adolescents. All cases underwent detailed autopsy evaluation by expert cardiac pathologists. Clinical information was obtained from referring coroners.
RESULTS
A structurally normal heart, indicative of sudden arrhythmic death syndrome was the most common autopsy finding (n = 474; 63%). Myocardial diseases were detected in 163 cases (22%), including arrhythmogenic cardiomyopathy (n = 36; 5%), hypertrophic cardiomyopathy (n = 31; 4%), idiopathic left ventricular hypertrophy (n = 31; 4%), and myocarditis (n = 30; 4%). Coronary artery anomalies were identified in 17 cases (2%). Decedents were competitive athletes in 128 cases (17%), and 159 decedents (21%) died during exercise. Arrhythmogenic cardiomyopathy was diagnosed in 8% of athletes compared with 4% of nonathletes (P = 0.05); coronary artery anomalies were significantly more common in athletes (9% vs 1%; P < 0.001), as well as commotio cordis (5% compared with 1% in nonathletes; P = 0.001). The 3 main comorbidities were asthma (n = 58; 8%), epilepsy (n = 44; 6%), and obesity (n = 40; 5%).
CONCLUSIONS
Sudden arrhythmic death syndrome and myocardial diseases are the most common conditions diagnosed at autopsy in adolescent victims of SCD. Among causes of SCD, arrhythmogenic cardiomyopathy, coronary artery anomalies, and commotio cordis are more common in young athletes than in similar age sedentary individuals.
Topics: Humans; Adolescent; Commotio Cordis; Death, Sudden, Cardiac; Athletes; Cardiomyopathies; United Kingdom; Coronary Artery Disease
PubMed: 36922085
DOI: 10.1016/j.jacc.2023.01.041 -
Journal of the American Society of... Dec 2012Multiple studies demonstrate a strong independent association between CKD and cardiovascular events including death, heart failure, and myocardial infarction. This... (Review)
Review
Multiple studies demonstrate a strong independent association between CKD and cardiovascular events including death, heart failure, and myocardial infarction. This review focuses on recent clinical studies that expand this spectrum of adverse cardiovascular events to include ventricular arrhythmias and sudden cardiac death. In addition, experimental models suggest structural remodeling of the heart and electrophysiologic changes in this population. These processes may explain the increased arrhythmic risk in kidney disease and aid in identifying patients who are at higher risk for sudden cardiac death. Finally, we review here the data to support the use of pharmacologic and device-based therapies for both the primary and secondary prevention of sudden cardiac death.
Topics: Animals; Death, Sudden, Cardiac; Defibrillators, Implantable; Humans; Renal Insufficiency, Chronic
PubMed: 23100219
DOI: 10.1681/ASN.2012010037