# Cardiovascular MRI Characterization of the Arrhythmogenic Heart in Nonischemic Cardiomyopathy

> **NIH NIH R01** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2021 · $810,587

## Abstract

PROJECT SUMMARY
Cardiovascular disease is the leading cause of morbidity and mortality. Sudden cardiac death (SCD) associated
with ventricular tachycardia or fibrillation (VT/VF) is responsible for 50% of deaths in patients with structural heart
disease. The implantable cardioverter defibrillator (ICD) is an established therapy for reducing arrhythmic
mortality. Current guidelines for use of primary prevention ICD (i.e., patients without VT/VF history, but at risk)
mainly emphasize left ventricular ejection fraction (LVEF). However, only a small percentage of ICD recipients
actually receive appropriate ICD shocks, resulting in unnecessary costs and morbidity. While there is strong
evidence that ICDs reduce mortality in patients with coronary artery disease, the benefit of primary prevention
ICDs in patients with nonischemic cardiomyopathy (NICM) is less robust. Furthermore, SCD mostly occurs in
patients with moderate systolic dysfunction who are currently not eligible for an ICD, further highlighting the
limitations of LVEF to choose appropriate ICD candidates. Given the limitations of LVEF, there is a pressing
need for better risk stratification strategies to identify which NICM patients are most likely to benefit from ICD
therapy. Our three specific aims seek to 1) identify the biological basis of cardiac MR (CMR) radiomic
phenotyping of the myocardium by investigating the association between endocardial/epicardial electrograms
(EGM) and CMR radiomic markers; 2) investigate CMR imaging markers that can identify patients with mild to
moderate systolic dysfunction (LVEF of 36% to 50%) at risk of ventricular arrhythmia, who are likely to benefit
from prophylactic ICD therapy and ultimately reduce total SCD burden; and 3) identify NICM patients with LVEF
35% undergoing primary prevention ICD implantation who are less likely to benefit from ICD by developing a
novel risk prediction model integrating CMR markers. Precise identification of individuals who are at risk of SCD
will (a) reduce mortality by offering ICD therapy to patients with mild to moderate systolic dysfunction who are
currently not eligible, and (b) reduce morbidity and healthcare costs in ICD-eligible patients who are at low risk
of SCD and unlikely to obtain a worthwhile benefit.

## Key facts

- **NIH application ID:** 10297650
- **Project number:** 2R01HL129185-05
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** Reza Nezafat
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $810,587
- **Award type:** 2
- **Project period:** 2015-08-15 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10297650

## Citation

> US National Institutes of Health, RePORTER application 10297650, Cardiovascular MRI Characterization of the Arrhythmogenic Heart in Nonischemic Cardiomyopathy (2R01HL129185-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10297650. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*