Cardiovascular magnetic resonance determinants of ventricular arrhythmic events after myocardial infarction
| Autor: | Alfredo Chauca, José T. Ortiz-Pérez, Giulio Falasconi, Xavier Bosch, Beatriz Jáuregui, Claudia Scherer, David Soto-Iglesias, Rodolfo San Antonio, Juan Carlos Acosta, Diego Penela, Lluís Mont, Susana Prat-González, Rosario J. Perea, Juan Fernández-Armenta, Antonio Berruezo, José M Carreño, Cheryl Teres, Augusto Ordóñez, Markus Linhart |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Magnetic Resonance Spectroscopy Cardiac magnetic resonance Arrhythmogenic substrate Myocardial Infarction Contrast Media Infarction Gadolinium Ventricular tachycardia Ventricular Function Left Cicatrix Ventricular arrhythmias Border zone channels Linear gingival erythema Physiology (medical) Internal medicine medicine Humans cardiovascular diseases Myocardial infarction Scar arrhythmogenicity Survival analysis Retrospective Studies Ejection fraction medicine.diagnostic_test business.industry Cardiac arrhythmia Arrhythmias Cardiac Stroke Volume Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging Case-Control Studies Tachycardia Ventricular Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | EP Europace. 24:938-947 |
| ISSN: | 1532-2092 1099-5129 |
| Popis: | Aims To non-invasively characterize, by means of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR), scar differences, and potential variables associated with ventricular tachycardia (VT) occurrence in chronic post-myocardial infarction (MI) patients. Methods and results A case–control study was designed through retrospective LGE-CMR data analysis of chronic post-MI patients (i) consecutively referred for VT substrate ablation after a first VT episode (n = 66) and (ii) from a control group (n = 84) with no arrhythmia evidence. The myocardium was characterized differentiating core, border zone (BZ), and BZ channels (BZCs) using the ADAS 3D post-processing imaging platform. Clinical and scar characteristics, including a novel parameter, the BZC mass, were compared between both groups. One hundred and fifty post-MI patients were included. Four multivariable Cox proportional hazards regression models were created for total scar mass, BZ mass, core mass, and BZC mass, adjusting them by age, sex, and left ventricular ejection fraction (LVEF). A cut-off of 5.15 g of BZC mass identified the cases with 92.4% sensitivity and 86.9% specificity [area under the ROC curve (AUC) 0.93 (0.89–0.97); P Conclusions The mass of BZC is the strongest independent variable associated with the occurrence of sustained monomorphic ventricular tachycardia in post-MI patients after adjustment for age, sex, and LVEF. Border zone channel mass measurement could permit a more accurate VT risk stratification than LVEF in chronic post-MI patients. |
| Databáze: | OpenAIRE |
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