Head-to-Head Comparison of T1 Mapping and Electroanatomical Voltage Mapping in Patients With Ventricular Arrhythmias.

Autor:	Sramko M; Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; First Faculty of Medicine, Charles University, Prague, Czech Republic., Abdel-Kafi S; Willem Einthoven Center for Cardiac Arrhythmia Research and Management (WECAM), Leiden, the Netherlands; Department of Cardiology, Heart-Lung-Centre, Leiden University Medical Center, Leiden, the Netherlands., Wijnmaalen AP; Willem Einthoven Center for Cardiac Arrhythmia Research and Management (WECAM), Leiden, the Netherlands; Department of Cardiology, Heart-Lung-Centre, Leiden University Medical Center, Leiden, the Netherlands., Tao Q; Department of Imaging Physics, Delft University of Technology, Delft, the Netherlands., van der Geest RJ; Division of Image Processing (LKEB), Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands., Lamb HJ; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands., Zeppenfeld K; Willem Einthoven Center for Cardiac Arrhythmia Research and Management (WECAM), Leiden, the Netherlands; Department of Cardiology, Heart-Lung-Centre, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: k.zeppenfeld@lumc.nl.
Jazyk:	angličtina
Zdroj:	JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2023 Jun; Vol. 9 (6), pp. 740-748. Date of Electronic Publication: 2023 Jan 18.
DOI:	10.1016/j.jacep.2022.10.035
Abstrakt:	Background: Electroanatomical voltage mapping (EAVM) has been compared with late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR), which cannot delineate diffuse fibrosis. T1-mapping CMR overcomes the limitations of LGE-CMR, but it has not been directly compared against EAVM. Objectives: This study aims to assess the relationship between left ventricular (LV) endocardial voltage obtained by EAVM and extracellular volume (ECV) obtained by T1 mapping. Methods: The study investigated patients who underwent endocardial EAVM for ventricular arrhythmias (CARTO 3, Biosense Webster) together with preprocedural contrast-enhanced T1 mapping (Ingenia 3T, Philips Healthcare). After image integration, EAVM datapoints were projected onto LGE-CMR and ECV-encoded images. Average values of unipolar voltage (UV), bipolar voltage (BV), LGE transmurality, and ECV were merged from corresponding cardiac segments (6 per slice) and pooled for analysis. Results: The analysis included data from 628 segments from 18 patients (57 ± 13 years of age, 17% females, LV ejection fraction 48% ± 14%, nonischemic/ischemic cardiomyopathy/controls: 8/6/4 patients). Based on the 95th and 5th percentile values obtained from the controls, ECV >33%, BV <2.9 mV, and UV <6.7 mV were considered abnormal. There was a significant inverse association between voltage and ECV, but only in segments with abnormal ECV. Increased ECV could predict abnormal BV and UV with acceptable accuracy (area under the curve of 0.78 [95% CI: 0.74-0.83] and 0.84 [95% CI: 0.79-0.88]). Conclusions: This study found a significant inverse relationship between LV endocardial voltage and ECV. Real-time integration of T1 mapping may guide catheter mapping and may allow identification of areas of diffuse fibrosis potentially related to ventricular arrhythmias. Competing Interests: Funding Support and Author Disclosures This work was partially supported by an ESC Research Grant received by Dr Sramko. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2023. Published by Elsevier Inc.)
Databáze:	MEDLINE
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