Appropriate ICD Interventions for Ventricular Arrhythmias Are Predicted by Higher Syntax Scores I and II in Patients with Ischemic Heart Disease
Aims. The occurrence of ventricular arrhythmias (VAs) in ischemic heart disease (IHD) patients is related to the presence and extent of fibrotic/scar tissue. As coronary atherosclerosis is the underlying cause of myocardial ischemia and fibrosis, in IHD patients implanted with an implantable cardiov...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-04-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/10/9/1843 |
| _version_ | 1797536532845821952 |
|---|---|
| author | Teresa Strisciuglio Giuseppe Ammirati Valerio Pergola Lucio Addeo Maria Angela Losi Aniello Viggiano Livio Imparato Vincenzo Russo Enrico Melillo Gerardo Nigro Giuseppe Stabile Antonio D’Onofrio Giovanni Esposito Antonio Rapacciuolo |
| author_facet | Teresa Strisciuglio Giuseppe Ammirati Valerio Pergola Lucio Addeo Maria Angela Losi Aniello Viggiano Livio Imparato Vincenzo Russo Enrico Melillo Gerardo Nigro Giuseppe Stabile Antonio D’Onofrio Giovanni Esposito Antonio Rapacciuolo |
| author_sort | Teresa Strisciuglio |
| collection | DOAJ |
| description | Aims. The occurrence of ventricular arrhythmias (VAs) in ischemic heart disease (IHD) patients is related to the presence and extent of fibrotic/scar tissue. As coronary atherosclerosis is the underlying cause of myocardial ischemia and fibrosis, in IHD patients implanted with an implantable cardioverter defibrillator (ICD) we investigated the relation between the VA burden and the complexity of coronary atherosclerotic lesions. Methods and results. In IHD patients who underwent coronary angiography and ICD implant, the Syntax scores I and II (SSI-II), as index of the severity of the coronary atherosclerotic disease, and the occurrence of VA were assessed. Overall 144 patients were included (123 males). Of these 22 patients (15%) experienced at least one episode of VA (cycle length 298 ± 19 msec) that required ICD intervention. The number of episodes per patient and per year was 4 ± 6 and 2.8 ± 4, respectively. Patients that experienced a VA compared to those free from arrhythmic events did not have distinct baseline clinical characteristics except for a higher SS I and SS II (21 (IQR 13–38) vs. 16 (IQR 10–23); <i>p</i> = 0.037; and 50 (IQR 39–62) vs. 42 (IQR 34–50); <i>p</i> = 0.012). In the binary logistic regression analyses the SS I and II were the only independent predictors of VA occurrence. A higher SS II was also associated with an earlier time to first event (<i>p</i> = 0.005). Conclusion. Higher SS I-II scores reflect a more severe coronary atherosclerosis and are associated with a greater VA burden. Further studies are needed to better clarify the ability of SSI-II to stratify the risk of IHD patients to develop life-threatening VA. |
| first_indexed | 2024-03-10T12:02:04Z |
| format | Article |
| id | doaj.art-a183452527af485e91dbd6045b79f423 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T12:02:04Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-a183452527af485e91dbd6045b79f4232023-11-21T16:54:51ZengMDPI AGJournal of Clinical Medicine2077-03832021-04-01109184310.3390/jcm10091843Appropriate ICD Interventions for Ventricular Arrhythmias Are Predicted by Higher Syntax Scores I and II in Patients with Ischemic Heart DiseaseTeresa Strisciuglio0Giuseppe Ammirati1Valerio Pergola2Lucio Addeo3Maria Angela Losi4Aniello Viggiano5Livio Imparato6Vincenzo Russo7Enrico Melillo8Gerardo Nigro9Giuseppe Stabile10Antonio D’Onofrio11Giovanni Esposito12Antonio Rapacciuolo13Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, ItalyDepartment of Medical Translational Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, ItalyDepartment of Medical Translational Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, ItalyDepartment of Medical Translational Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, ItalyDepartment of Cardiology, Clinica Montervergine, 83013 Mercogliano, ItalyDepartment of Medical Translational Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, ItalyAims. The occurrence of ventricular arrhythmias (VAs) in ischemic heart disease (IHD) patients is related to the presence and extent of fibrotic/scar tissue. As coronary atherosclerosis is the underlying cause of myocardial ischemia and fibrosis, in IHD patients implanted with an implantable cardioverter defibrillator (ICD) we investigated the relation between the VA burden and the complexity of coronary atherosclerotic lesions. Methods and results. In IHD patients who underwent coronary angiography and ICD implant, the Syntax scores I and II (SSI-II), as index of the severity of the coronary atherosclerotic disease, and the occurrence of VA were assessed. Overall 144 patients were included (123 males). Of these 22 patients (15%) experienced at least one episode of VA (cycle length 298 ± 19 msec) that required ICD intervention. The number of episodes per patient and per year was 4 ± 6 and 2.8 ± 4, respectively. Patients that experienced a VA compared to those free from arrhythmic events did not have distinct baseline clinical characteristics except for a higher SS I and SS II (21 (IQR 13–38) vs. 16 (IQR 10–23); <i>p</i> = 0.037; and 50 (IQR 39–62) vs. 42 (IQR 34–50); <i>p</i> = 0.012). In the binary logistic regression analyses the SS I and II were the only independent predictors of VA occurrence. A higher SS II was also associated with an earlier time to first event (<i>p</i> = 0.005). Conclusion. Higher SS I-II scores reflect a more severe coronary atherosclerosis and are associated with a greater VA burden. Further studies are needed to better clarify the ability of SSI-II to stratify the risk of IHD patients to develop life-threatening VA.https://www.mdpi.com/2077-0383/10/9/1843ventricular arrhythmiascoronary artery diseaseimplantable cardiac defibrillatorheart failure |
| spellingShingle | Teresa Strisciuglio Giuseppe Ammirati Valerio Pergola Lucio Addeo Maria Angela Losi Aniello Viggiano Livio Imparato Vincenzo Russo Enrico Melillo Gerardo Nigro Giuseppe Stabile Antonio D’Onofrio Giovanni Esposito Antonio Rapacciuolo Appropriate ICD Interventions for Ventricular Arrhythmias Are Predicted by Higher Syntax Scores I and II in Patients with Ischemic Heart Disease Journal of Clinical Medicine ventricular arrhythmias coronary artery disease implantable cardiac defibrillator heart failure |
| title | Appropriate ICD Interventions for Ventricular Arrhythmias Are Predicted by Higher Syntax Scores I and II in Patients with Ischemic Heart Disease |
| title_full | Appropriate ICD Interventions for Ventricular Arrhythmias Are Predicted by Higher Syntax Scores I and II in Patients with Ischemic Heart Disease |
| title_fullStr | Appropriate ICD Interventions for Ventricular Arrhythmias Are Predicted by Higher Syntax Scores I and II in Patients with Ischemic Heart Disease |
| title_full_unstemmed | Appropriate ICD Interventions for Ventricular Arrhythmias Are Predicted by Higher Syntax Scores I and II in Patients with Ischemic Heart Disease |
| title_short | Appropriate ICD Interventions for Ventricular Arrhythmias Are Predicted by Higher Syntax Scores I and II in Patients with Ischemic Heart Disease |
| title_sort | appropriate icd interventions for ventricular arrhythmias are predicted by higher syntax scores i and ii in patients with ischemic heart disease |
| topic | ventricular arrhythmias coronary artery disease implantable cardiac defibrillator heart failure |
| url | https://www.mdpi.com/2077-0383/10/9/1843 |
| work_keys_str_mv | AT teresastrisciuglio appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT giuseppeammirati appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT valeriopergola appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT lucioaddeo appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT mariaangelalosi appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT anielloviggiano appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT livioimparato appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT vincenzorusso appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT enricomelillo appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT gerardonigro appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT giuseppestabile appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT antoniodonofrio appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT giovanniesposito appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease AT antoniorapacciuolo appropriateicdinterventionsforventriculararrhythmiasarepredictedbyhighersyntaxscoresiandiiinpatientswithischemicheartdisease |