Structural assessment of myocardial infarction scars and left ventricular function with cardiac magnetic resonance imaging in patients at high risk of sudden cardiac death

Bratislava Medical Journal

article

V. Neuschl¹  Z. Berecova²  J. Madaric³  J. Simkova¹  A. Glezlova¹  R. Hatala³ 

[1] Institute of Diagnostic Imaging;Department of Radiology, St Michal Hospital;Department of Arrhythmias and Cardiac Pacing, Academic Division of Cardiology and Angiology, Medical Faculty, Slovak Medical University and National Cardiovascular Institute – NUSCH Bratislava

关键词: myocardial infarction;    cardiac magnetic resonance imaging;    ventricular tachyarrhythmias;    sudden cardiac death;    implantable cardioverter defibrillator;   

DOI  :  10.4149/BLL_2018_048

学科分类：医学（综合）

来源: AEPress, s.r.o.

【 摘 要 】

OBJECTIVES: Results of qualitative and quantitative analyses of scars and LV (left ventricle) function acquired by means of cardiac magnetic resonance (CMR) were correlated with a subsequent occurrence of malignant ventricular arrhythmias in patients at high risk of sudden cardiac death (SCD). METHODS: We have prospectively followed 47 patients (mean age 60 ± 11 years) who were hospitalized for an implantable cardioverter-defibrillator (ICD) implantation to prevent SCD. All post-MI patients had severe residual LV dysfunction (LVEF 33±14%). Patients were examined with CMR. Based on CMR analysis, we evaluated the basic functional parameters of LV as well as mass, volume, transmurality and heterogeneity of the post-MI scar. RESULTS: The patients with malignant arrhythmias were characterized by smaller LV end-diastolic diameters (LVED 192 ± 79 vs 254 ± 47 mm, p = 0.003) and end-systolic diameters (LVES 131 ± 80 vs 181 ± 45 mm, p = 0.01). As for the other observed functional and morphological CMR parameters, no significant differences between the two groups were detected. CONCLUSION: These results indicate that post-MI patients with severe residual left ventricular dysfunction and dilatation are in the long term characterized by a lower incidence of malignant arrhythmias compared to the patients with less dilated LV with a comparably severe LV dysfunction (Tab. 2, Fig. 3, Ref. 26). Text in PDF www.elis.sk.

【 授权许可】

CC BY