Myocardial Substrate Characterization by CMR T1 Mapping in Patients With NICM and No LGE Undergoing Catheter Ablation of VT
Autor: | Pasquale Santangeli, Sanjay Dixit, Simon A. Castro, David Lin, David S. Frankel, Cory M. Tschabrunn, Robert D. Schaller, Andres Enriquez, Jeffrey Arkles, Silvia Magnani, Matthew C. Hyman, Saman Nazarian, Erica S. Zado, Gaetano Nucifora, Gregory E. Supple, Daniele Muser, C. Anwar A. Chahal, Francis E. Marchlinski, David J. Callans, Ramanan Kumareswaran |
---|---|
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Catheter ablation Dilative cardiomyopathy 030204 cardiovascular system & hematology Ventricular tachycardia medicine.disease 03 medical and health sciences 0302 clinical medicine Diffuse fibrosis Internal medicine medicine Cardiology Late gadolinium enhancement In patient 030212 general & internal medicine Cardiac magnetic resonance Inverse correlation business |
Zdroj: | JACC: Clinical Electrophysiology. 7:831-840 |
ISSN: | 2405-500X |
Popis: | Objectives The goal of this study was to characterize the relationship between DF, the electroanatomic mapping (EAM) substrate, and outcomes of catheter ablation of VT in NICM. Background A substantial proportion of patients with nonischemic dilated cardiomyopathy (NICM) and ventricular tachycardia (VT) do not have scar detectable by cardiac magnetic resonance late gadolinium enhancement (LGE) imaging. In these patients, the significance of diffuse fibrosis (DF) detected with T1 mapping has not been previously investigated. Methods This study included 51 patients with NICM and VT undergoing catheter ablation (median age 55 years; 77% male subjects) who had no evidence of LGE on pre-procedural cardiac magnetic resonance. Post-contrast T1 relaxation time determined on the septum was assessed as a surrogate of DF burden. The extent of endocardial low-voltage areas (LVAs) at EAM was correlated with T1 mapping data. Results Bipolar LVAs were present in 22 (43%) patients (median extent 15 cm2 [8 to 29 cm2]) and unipolar LVA in all patients (median extent 48 cm2 [26 to 120 cm2]). A significant inverse correlation was found between T1 values and both unipolar-LVA (R2 = 0.64; β = –0.85; p Conclusions In patients with NICM and no evidence of LGE undergoing catheter ablation of VT, DF estimated by using post-contrast T1 mapping correlates with the voltage abnormality at EAM and seems to affect post-ablation outcomes. |
Databáze: | OpenAIRE |
Externí odkaz: |