scholarly journals Sudden Cardiac Death in Systemic Sclerosis: Diagnostics to Assess Risk and Inform Management

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1781
Author(s):  
Laura Ross ◽  
Elizabeth Paratz ◽  
Murray Baron ◽  
André La Gerche ◽  
Mandana Nikpour
Keyword(s):  
Heart Disease ◽  
Systemic Sclerosis ◽  
Sudden Cardiac Death ◽  
Cardiac Disease ◽  
Cardiac Death ◽  
Diffuse Myocardial Fibrosis ◽  
Future Research ◽  
Disease Course ◽  
Future Research Agenda ◽  
Increased Risk

Cardiac disease is a leading cause of death in systemic sclerosis (SSc) and sudden cardiac death (SCD) is thought to occur more commonly in SSc than in the general population. Diffuse myocardial fibrosis, myocarditis and ischaemic heart disease are all prevalent in SSc and can be reasonably hypothesised to contribute to an increased risk of SCD. Despite this, SCD remains a relatively understudied area of SSc with little understood about SSc-specific risk factors and opportunities for primary prevention. In this review, we present an overview of the possible mechanisms of SCD in SSc and our current understanding of how each of these mechanisms may contribute to cardiac death. This review highlights the need for a future research agenda that addresses the underlying epidemiology of SCD in SSc and identifies opportunities for intervention to modify the disease course of heart disease in SSc.

Evidence for the Cardioprotective Effects of Omega-3 Fatty Acids

2002 ◽  
Vol 36 (12) ◽  
pp. 1950-1956 ◽  
Author(s):  
Douglas N Carroll ◽  
Mary T Roth
Keyword(s):  
Myocardial Infarction ◽  
Fatty Acids ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Serum Triglyceride ◽  
Biomedical Literature ◽  
Omega 3 ◽  
Increased Risk

OBJECTIVE: To review available literature regarding the cardiovascular effects of marine-derived ω-3 fatty acids and evaluate the benefit of these fatty acids in the prevention of coronary heart disease. DATA SOURCES: Biomedical literature accessed through a MEDLINE search (1966–April 2002). Search terms included fish oil, omega-3 fatty acid, sudden death, hypertriglyceridemia, myocardial infarction, and mortality. DATA SYNTHESIS: Following an early 1970's observational investigation that ω-3 fatty acids may reduce the occurrence of myocardial infarction—related deaths in Greenland Eskimos, additional trials have been conducted that support this finding. Epidemiologic and clinical trial data suggest that ω-3 fatty acids may reduce the risk of cardiovascular-related death by 29–52%. In addition, the risk of sudden cardiac death was found to be reduced by 45–81%. Possible mechanisms for these beneficial effects include antiarrhythmic properties, improved endothelial function, antiinflammatory action, and reductions in serum triglyceride concentrations. ω-3 Fatty acids are fairly well tolerated; potential adverse effects include bloating and gastrointestinal distress, “fishy taste” in the mouth, hyperglycemia, increased risk of bleeding, and a slight increase in low-density-lipoprotein cholesterol. CONCLUSIONS: ω-3 Fatty acids may be beneficial and should be considered in patients with documented coronary heart disease. They may be particularly beneficial for patients with risk factors for sudden cardiac death.

scholarly journals Sudden Cardiac Death

2021 ◽  
pp. 32-41
Author(s):  
Omar Elsaka
Keyword(s):  
Heart Disease ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Public Health Problem ◽  
The United States ◽  
Left Ventricular ◽  
Future Research ◽  
Large Size ◽  
Artery Disease ◽  
Lake Size

Background: Sudden cardiac death (SCD) remains a major open clinical and public health problem, with an estimated 300,000 deaths per year in the United States. The possibility of identifying potential SCD victims is limited by the large size of the large number of SCD victims and the apparent time-dependent risk of sudden death. The latter refers to the tendency of SCDs to detect other cardiovascular events during the most dangerous period of 6–18 months following a major cardiovascular event and the risk of subsequent collapse. The combination of time and lake size provides the basis for future research to find more vulnerable people. Pathologically, SCD can be seen as an interaction between some electrophysiological events that causes abnormalities in cardiac structure, temporal dysfunction, and malignant arrhythmias. Structural deformities represent an anatomical matrix of chronic risk and include the effects of electrophysiological anatomical abnormalities such as coronary artery disease, left ventricular hypertrophy, myopathic ventricles, and bypass leaflets in the myocardium. Conclusion: Macroscopic cardiac features are common in about one-third of young SCD victims. However, in 79% of them, histological studies reveal hidden pathological features such as local myocarditis, heart disease and motor system disorders. A total of 16 (6%) victims had no evidence of systemic heart disease and the mechanism of SCD was not described.

Sudden cardiac death: epidemiology and prevention

2015 ◽  
Author(s):  
Hans-Richard Arntz
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Beta Blockers ◽  
Left Ventricular ◽  
Industrialized Countries ◽  
Pharmacological Prevention ◽  
Increased Risk ◽  
Genetically Determined

Even if sudden cardiac death is considered to be the most frequent cause of death in adults in industrialized countries, its incidence varies widely, depending on the definition and the source and quality of underlying data. It is estimated that about 70-80% of cases are due to coronary heart disease. The remaining 20% are attributable to a wide variety of inborn, genetically determined or acquired diseases, including a small group with hitherto undefined background. Prevention primarily encompasses the treatment of cardiovascular risk factors to avoid manifestations of coronary heart disease. Furthermore, preventive strategies are targeted to define groups of patients with an increased risk for sudden cardiac death or individuals at risk in specific populations, e.g. competitive athletes. A major target group are patients with impaired left ventricular function, preferentially due to myocardial infarction. These patients, and some less clearly defined patient groups with non-ischaemic cardiomyopathy and heart failure, may benefit from the insertion of an implantable cardioverter-defibrillator. With regard to pharmacological prevention, treatment of the underlying condition is the mainstay, since no antiarrhythmic substance-with the exemption of beta-blockers in some situations-has shown to be of efficacy.

P6137Trends in mortality of sudden cardiac death in Brazil

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Moreira ◽  
G L S Silva ◽  
G M B Sahium ◽  
M M Faria ◽  
J P S Pereira ◽  
...  
Keyword(s):  
Heart Disease ◽  
Sudden Cardiac Death ◽  
Cardiac Disease ◽  
Cardiac Death ◽  
Direct Method ◽  
Adult Population ◽  
Accurate Determination ◽  
Age Groups ◽  
National Database ◽  
Death Certificates

Abstract Background Sudden cardiac death (SCD) is the most feared manifestation of heart disease. In the past few decades, substantial progress has been made in our understanding of SCD and in its prevention. However, there is no data concerning population incidence of SCD in Brazil. Purpose To estimate trends of mortality for SCD in Brazil between 1996 and 2015. Methods Data from death certificates in Brazil from 1996 to 2015 were obtained by consulting the Mortality Information System (SIM) national database. SCD was defined as deaths occurring out of the hospital (residence or public way) with an underlying cause of death reported as a cardiac disease (ICD-9 code 390–398, 402, or 404–429; ICD-10 code I00-I09, I11, I20-I51). Annual death rates (deaths/100,000 inhabitants) were calculated for the population aged ≥20 years and standardized by the direct method to the 2010 Brazilian Census population. Trend analyses in the period were performed using Poisson regression. Results In 2015, there were 200,372 cardiac disease deaths among Brazilian adult population, of which 63,390 (31.6%) were defined as SCD. Over this 20-years period, 1,002,648 deaths were attributed to SCD, and coronary heart disease was the underlying cause on 59% of death certificates. The adjusted mortality rate ranged from 52.9 in 1996 to 39.7 deaths/100,000 inhabitants in 2015 (R2=0.685, P<0.001). This reduction in SCD mortality was more pronounced among women (50.4 to 34.0 deaths/100,000 inhabitants; R2=0.785, P<0.001) than men (59.7 to 49.9 deaths/100,000 inhabitants; R2=0.477, P=0.03). With the exception of individuals aged 20 to 39 years, in the all other age groups this reduction in mortality was also significant. Conclusions This data gives an insight into the pattern of SCD deaths in a big developing country. Despite the inherent limitations in collecting information based on death certificates, in addition to the absence of a clear national standardized definition of SCD, it is possible to affirm that there was a reduction in mortality due to SCD in the last 20 years in Brazil. Prospective surveillance programs would enable more accurate determination of SCD burden in the community.

Risk stratification for sudden cardiac death in the general population

ESC CardioMed ◽  
2018 ◽  
pp. 2305-2308
Author(s):  
Efstathios K. Iliodromitis ◽  
Dimitrios Farmakis
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Sudden Cardiac Death ◽  
General Population ◽  
Risk Stratification ◽  
Cardiac Death ◽  
Increased Risk ◽  
Artery Disease

There are three main groups in the general population as far as sudden cardiac death (SCD) is concerned: individuals without a known history or predisposing factors for heart disease; individuals with known risk factors for heart disease or SCD; and patients with diagnosed ischaemic, structural, or electrical cardiac conditions, acquired or genetic, that are associated with an increased risk for SCD. Although SCD literature focuses mainly on patients with known heart disease, approximately 50% of SCD cases occur in individuals belonging to the first two groups. The annual incidence of SCD in the general population ranges between 0.6 and greater than 1.4 per 1000 individuals. SCD occurs more commonly in men than in women and with an incidence that increases with age due to the increase in coronary artery disease. The commonest aetiologies for SCD in the general population are coronary artery disease and cardiomyopathy, accounting for 80% and 10–15% of cases, respectively. A number of factors have been related to an increased risk for SCD in the general population including genetic predisposition, risk factors for atherosclerosis, strenuous physical activity and sports, electrocardiographic abnormalities, elevated levels of biomarkers, and abnormalities in imaging and other diagnostic techniques. However, large-scale prospective studies that confirm the feasibility, clinical efficacy, and cost-effectiveness of using these factors for broad mass screening for SCD are generally lacking and therefore risk stratification for SCD in the general population remains challenging.

Postmortem Specificity of Troponin for Acute Miocard Infarction Diagnosis throug Qualitative Dosing from Pericardial Fluid

2018 ◽  
Vol 69 (9) ◽  
pp. 2482-2486
Author(s):  
Iuliana Hunea ◽  
Simona Irina Damian ◽  
Carmen Corina Radu ◽  
Sorin Moldoveanu ◽  
Tatiana Iov
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Disease ◽  
Cardiac Death ◽  
Troponin I ◽  
Troponin T ◽  
Morphological Changes ◽  
Pericardial Fluid ◽  
Histological Changes ◽  
Lethal Arrhythmia ◽  
Myocardial Lesions

Cardiac disease is the leading cause of death, and sudden cardiac death occupies the first place in sudden deaths of natural causes. Sudden cardiac death due to lethal arrhythmia may be the first manifestation of a cardiac disease, such cases becoming suspect dead, thus forensic cases. The autopsy performed in such cases may reveal important cardiovascular disease but not obvious macroscopic or histological changes of acute myocardial infarction (IMA), except for cases of survival for several hours after the onset of the symptomatology. Biochemical markers were used to test for myocardial lesions in the absence of morphological changes. Methods for determining myoglobin, CK-MB, troponin T (cTn T), troponin I (cTn I) were introduced to the clinic to diagnose the condition of patients with chest pain as early as the 1990s. The lack of pathognomonic elements in corps investigations, where part of the analysis cannot be carried out, requires verification of the value of the investigations that can be carried out, with reference to the biochemical in the present case, in establishing the diagnosis with certainty.

Association between digoxin use and sudden cardiac death in individuals with the rs10494366 variant of the NOS1AP gene

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Soroush ◽  
A Aarnoudse ◽  
F Shokri ◽  
M Van Den Berg ◽  
F Ahmadizar ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Smoking Status ◽  
Adaptor Protein ◽  
Therapeutic Window ◽  
P Value ◽  
Qtc Interval ◽  
Total Study Population ◽  
Increased Risk

Abstract Background Digoxin is one of the oldest cardiovascular medications still used to treat heart failure and atrial fibrillation. Due to its narrow therapeutic window, it is associated with life threatening intoxication and arrhythmias, and with QTc-shortening. Common genetic variation in the nitric oxide synthase-1 adaptor protein (NOS1AP) has been associated with QTc interval prolongation. Purpose We investigated whether the rs10494366 variant of the NOS1AP gene modified the risk of SCD in patients using digoxin. Methods In a prospective population-based cohort study, we included data of the three cohorts, started as of January 1st, 1991 until January 1st 2014. Digoxin current use on the date of cardiac death in cases and the same day of follow-up in the remainder of the cohort was a time-dependent exposure. The main outcome was SCD defined as sudden and unexpected death as a result of cardiac causes, according to international criteria. Identification and adjudication of SCD was performed independently, before the start of this study. We used Cox proportional hazard regression analysis to investigate the associations between NOS1AP rs10494366 variant and incident SCD among digoxin users compared to non-users. Associations were adjusted for age, sex (model 1) in addition to BMI, prevalent diabetes, myocardial infarction, baseline hypertension and smoking status (past, current, never) (model 2). Results We included 14,594 individuals, with a mean age of 65.3 (SD 10.3) years. Almost 59% were female. The cumulative incidence of SCD was 9.5% (609 cases) by the end of follow up. Among them, 98 (16%) individuals were exposed to digoxin at the time of death. In model 1, NOS1AP rs10494366 variant was not associated with SCD in the total study population. However, an interaction term of the gene with the daily dose of digoxin was significantly associated with increased risk of SCD (p-value 0.0001). In model 2, the risk of SCD in current users of digoxin was 4.2 [95% CI 1.3–13.8] for the GG genotype; 2.1 [95% CI 1.1–4.2] for the GT genotype, and 1.5 [95% CI 0.7–3.2] for the TT genotype. Conclusion NOS1AP rs10494366 variant modified the risk of sudden cardiac death in users of digoxin. Our study suggests that individuals with the homozygous minor GG allele have a fourfold increased risk of sudden cardiac death. Funding Acknowledgement Type of funding source: None

N-terminal pro-brain natriuretic peptide and sudden cardiac death in hypertrophic cardiomyopathy

Heart ◽  
2020 ◽  
pp. heartjnl-2020-317701
Author(s):  
Guixin Wu ◽  
Jie Liu ◽  
Shuiyun Wang ◽  
Shiqin Yu ◽  
Ce Zhang ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Sudden Cardiac Death ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Cardiac Death ◽  
Cardiac Fibrosis ◽  
Discrimination Performance ◽  
Net Reclassification Improvement ◽  
C Statistic ◽  
Increased Risk

ObjectiveElevated levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) are associated with heart failure-related death in hypertrophic cardiomyopathy (HCM), but the relationship between NT-proBNP level and sudden cardiac death (SCD) in HCM remains undefined.MethodsThe study prospectively enrolled 977 unrelated patients with HCM with available NT-proBNP results who were prospectively enrolled and followed for 3.0±2.1 years. The Harrell’s C-statistic under the receiver operating characteristic curve was calculated to evaluate discrimination performance. A combination model was constructed by adding NT-proBNP tertiles to the HCM Risk-SCD model. The correlation between log NT-proBNP level and cardiac fibrosis as measured by late gadolinium enhancement (LGE) or Masson’s staining was analysed.ResultsDuring follow-up, 29 patients had SCD. Increased log NT-proBNP levels were associated with an increased risk of SCD events (adjusted HR 22.27, 95% CI 10.93 to 65.63, p<0.001). The C-statistic of NT-proBNP in predicting SCD events was 0.80 (p<0.001). The combined model significantly improved the predictive efficiency of the HCM Risk-SCD model from 0.72 to 0.81 (p<0.05), with a relative integrated discrimination improvement of 0.002 (p<0.001) and net reclassification improvement of 0.67 (p<0.001). Furthermore, log NT-proBNP levels were significantly correlated with cardiac fibrosis as detected either by LGE (r=0.257, p<0.001) or by Masson’s trichrome staining in the myocardium (r=0.198, p<0.05).ConclusionNT-proBNP is an independent predictor of SCD in patients with HCM and may help with risk stratification of this disease.

scholarly journals B-PO05-190 ATHLETES WITH SUDDEN CARDIAC DEATH-PREDISPOSING GENETIC HEART DISEASE: WINNING THE ‘RETURN-TO-PLAY’ GAME

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S449
Author(s):  
Kathryn E. Tobert ◽  
Johan Martijn Bos ◽  
Ramin Garmany ◽  
Michael John Ackerman
Keyword(s):  
Heart Disease ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Return To Play ◽  
Play Game ◽  
Genetic Heart Disease

scholarly journals Vital exhaustion and sudden cardiac death in the Atherosclerosis Risk in Communities Study

Heart ◽  
2017 ◽  
Vol 104 (5) ◽  
pp. 423-429 ◽  
Author(s):  
Brittany M Bogle ◽  
Nona Sotoodehnia ◽  
Anna M Kucharska-Newton ◽  
Wayne D Rosamond
Keyword(s):  
Risk Factors ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Disease Risk ◽  
Ventricular Tachyarrhythmia ◽  
Atherosclerosis Risk In Communities ◽  
Vital Exhaustion ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Aric Study

ObjectiveVital exhaustion (VE), a construct defined as lack of energy, increased fatigue and irritability, and feelings of demoralisation, has been associated with cardiovascular events. We sought to examine the relation between VE and sudden cardiac death (SCD) in the Atherosclerosis Risk in Communities (ARIC) Study.MethodsThe ARIC Study is a predominately biracial cohort of men and women, aged 45–64 at baseline, initiated in 1987 through random sampling in four US communities. VE was measured using the Maastricht questionnaire between 1990 and 1992 among 13 923 individuals. Cox proportional hazards models were used to examine the hazard of out-of-hospital SCD across tertiles of VE scores.ResultsThrough 2012, 457 SCD cases, defined as a sudden pulseless condition presumed due to a ventricular tachyarrhythmia in a previously stable individual, were identified in ARIC by physician record review. Adjusting for age, sex and race/centre, participants in the highest VE tertile had an increased risk of SCD (HR 1.48, 95% CI 1.17 to 1.87), but these findings did not remain significant after adjustment for established cardiovascular disease risk factors (HR 0.94, 95% CI 0.73 to 1.20).ConclusionsAmong participants of the ARIC study, VE was not associated with an increased risk for SCD after adjustment for cardiovascular risk factors.

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