Interview with Dr Amgad N. Makaryus

Posted Tue, Jan, 19,2016

This author interview is by Dr Amgad N. Makaryus, of Hofstra NSLIJ School of Medicine,. Dr Makaryus' full paper, Echocardiographic Predictors of Ventricular Tachycardia, is available for download in Clinical Medicine Insights: Cardiology.

Please summarize for readers the content of your article.
Patients with structural heart disease are at risk for ventricular tachycardia (VT) and ventricular fibrillation (VF), which account for the majority of sudden cardiac deaths (SCDs). We sought to examine echocardiographic parameters that can predict VT as documented by implantable cardioverter-defibrillator (ICD) appropriate discharge. We examine echocardiographic parameters other than ejection fraction that may predict VT as recorded via rates of ICD discharge.

How did you come to be involved in your area of study?
The North Shore-LIJ Health System in New York, USA, is a busy tertiary care health system where numerous patients with structural heart disease are followed and evaluated. I became involved in this study while directing the echocardiography laboratory at North Shore University Hospital in Manhasset, NY, USA.

What was previously known about the topic of your article?
Prior studies have studied looked at echocardiographic predictors of VT. While left ventricular ejection fraction has proven to be a valuable echocardiographic parameter for determination of risk of ventricular arrhythmias, and therefore ICD eligibility, the question often arises of whether other parameters that are routinely assessed during echocardiography have the potential to serve as additional indicators of prognosis as well as predictors of future risk of SCD in patients deemed to be at risk of developing malignant ventricular arrhythmias. We sought to look at a large cohort and specifically evaluate multiple echocardiographic parameters for predication of VT.

How has your work in this area advanced understanding of the topic?
The determination of echocardiographic parameters that can be used to reliably assess the risk of the development of life-threatening ventricular arrhythmias can theoretically improve outcomes by guiding alterations in either pharmacologic or electrophysiologic therapy and in risk stratification prior to consideration for ICD implantation. Our study should provide the impetus for more large-scale studies evaluating the utility of readily available echocardiographic parameters as predictors of ventricular arrhythmias.

What do you regard as being the most important aspect of the results reported in the article?
Our study demonstrates that the main echocardiographic predictor associated with the first occurrence of VT was LVIDs >4 cm. Patients with an LVIDs >4 cm were 2.5 times more likely to have an episode of VT. Changes in these echocardiographic parameters may warrant aggressive pharmacologic therapy and implantation of an ICD.

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