We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Scar Characteristics for Prediction of Ventricular Arrhythmia in Ischemic Cardiomyopathy.
- Authors
GOUDA, SHERIF; ABDELWAHAB, AMIR; SALEM, MOHAMED; HAMID, MAGDY ABDEL
- Abstract
Background Better risk-stratification tools are needed to identify the best candidates for implantable cardioverter defibrillator implantation. Infarct characterization by cardiac magnetic resonance (CMR) has become an evolving potential tool for risk stratification. Objective We assessed the ability of scar characteristics by CMR in patients with postinfarction left ventricular (LV) dysfunction to predict sustained monomorphic ventricular tachycardia (SMVT). Methods Forty-eight patients with postinfarction LV dysfunction underwent CMR study. Twenty-four patients had history of SMVT and the other 24 were control group and underwent electrophysiological study to assess SMVT inducibilty. Various scar characteristics were assessed in the spontaneous SMVT group and were compared with the inducible and noninducible SMVT groups. Results Only six patients in the control group had inducible SMVT. In univariable analysis, total scar (absolute and as percent of LV), scar core (absolute and as percent of LV), peri-infarct zone (absolute and as percent of LV), mean infarct transmurality, and number of segments with late gadolinium enhancement (LGE) were statistically significant predictors of spontaneous SMVT experience and SMVT inducibility. In multivariable analysis, total infarct as percent of LV mass was the only significant independent predictor of spontaneous SMVT experience (odds ratio [OR] 1.33 per% change, 95% confidence interval [CI] 1.12-1.6, P = 0.001) and SMVT inducibility (OR 1.3 per% change, 95% CI 1.1-1.6, P = 0.004). Conclusion Characterization of myocardial infarct by LGE-CMR, specifically total infarct size, is better predictor of spontaneous SMVT experience and SMVT inducibility than LV ejection fraction.
- Subjects
VENTRICULAR tachycardia; CARDIAC arrest; MAGNETIC resonance imaging; RISK assessment; ELECTROPHYSIOLOGY methodology; CONFIDENCE intervals; FISHER exact test; MULTIVARIATE analysis; CARDIOMYOPATHIES; SCARS; STATISTICS; T-test (Statistics); LOGISTIC regression analysis; RECEIVER operating characteristic curves; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio; DISEASE risk factors; CARDIOVASCULAR diseases risk factors
- Publication
Pacing & Clinical Electrophysiology, 2015, Vol 38, Issue 3, p311
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/pace.12536