Myocardial Extracellular Volume Is Not Associated With Malignant Ventricular Arrhythmias in High-risk Hypertrophic Cardiomyopathy

Mirelis, J. González; Sánchez‐González, Javier; Zorio, Esther; Ripoll‐Vera, Tomás; Salguero‐Bodes, Rafael; Filgueiras-Rama, David; González-López, Esther; Gallego‐Delgado, María; Fernández‐Jiménez, Rodrigo; Soleto, María Jesús; Núñez, Juana; Pizarro, Gonzalo; Sanz, Javier; Fuster, Valentín; García‐Pavía, Pablo; Ibáñez, Borja

doi:10.1016/j.rec.2017.01.026

Cited by 2 publications

(2 citation statements)

References 44 publications

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“…Adding to the lack of clarity on the matter, the comparison of the ECV values between patients with and without nsVT by Chung et al showed no statistically significant differences [37]. Furthermore, Mirelis et al showed that ECV was not increased in ICD-implanted HCM patients with malignant ventricular arrhythmias vs. those without arrhythmias; however, in this study, the ECV was assessed by computed tomography [38]. In our group, the average ECV was approximately 28%, which is a figure that is slightly lower than that reported by Levine and Avanessov; nevertheless, septal ECV values were higher, reaching 30.5% in patients with documented nsVT.…”

Section: Interstitial Fibrosismentioning

confidence: 55%

The Relationship between Cardiac Magnetic Resonance-Assessed Replacement and Interstitial Fibrosis and Ventricular Arrhythmias in Hypertrophic Cardiomyopathy

Karabinowska-Małocha

Dziewięcka

Banyś

et al. 2022

JPM

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Non-sustained ventricular tachycardia (nsVT) creates the electrical basis for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). We aimed to evaluate the relationship between interstitial fibrosis on cardiac magnetic resonance (CMR) and nsVT in HCM. A total of 50 HCM patients underwent CMR with a 3 T scanner to determine the presence of replacement fibrosis expressed by late gadolinium enhancement (LGE), and interstitial fibrosis expressed by native T₁, post-contrast T₁, and extracellular volume (ECV). The incidence of nsVT was assessed by Holter monitoring. We detected nsVT in 14 (28%) out of 50 HCM patients. Replacement fibrosis expressed by LGE was present in 37 (74%) patients and only showed a trend towards a differentiation between the groups with and without nsVT (p = 0.07). However, the extent of LGE was clearly higher in the nsVT group (3.8 ± 4.9% vs. 7.94 ± 4.5%, p = 0.002) and was an independent predictor of nsVT in a multivariable regression analysis (OR 1.2; 95%CI 1.02–1.4; p = 0.02). No relationship was observed between interstitial fibrosis and nsVT. To conclude, it was found that it is not the mere presence but the actual extent of LGE that determines the occurrence of nsVT in HCM patients; the role of interstitial fibrosis remains unclear.

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Section: Interstitial Fibrosismentioning

confidence: 55%

The Relationship between Cardiac Magnetic Resonance-Assessed Replacement and Interstitial Fibrosis and Ventricular Arrhythmias in Hypertrophic Cardiomyopathy

Karabinowska-Małocha

Dziewięcka

Banyś

et al. 2022

JPM

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“…Ohta et al (9) used a 2-contrast injection protocol: one with an infusion of 0.9 mL/kg of body weight for coronary CT angiography followed by another injection of 0.5 mL/kg of body weight immediately after coronary CT angiography. To obtain good contrast between myocardial tissue and the left ventricular cavity on CT delayed enhancement images, the amount of iodine contrast medium used for calculating ECV has ranged from 120 to 147 mL in some previous studies (23,26,27). These relatively big volumes of iodine contrast in a single contrast injection protocol may result in a high density of contrast material in the right heart cavities, which may cause streak artifacts affecting the lumen evaluation of the proximal right coronary artery.…”

Section: A B Cmentioning

confidence: 99%

Quantitative analysis of late iodine enhancement using dual-layer spectral detector computed tomography: comparison with magnetic resonance imaging

Liu¹,

Lin²,

Xu³

et al. 2022

Quant Imaging Med Surg

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Background: To evaluate the segmental myocardial extracellular volume (ECV) fraction and to define a threshold ECV value that can be used to distinguish positive late gadolinium enhancement (LGE) segments from negative myocardial segments using dual-layer spectral detector computed tomography (SDCT), with magnetic resonance imaging (MRI) as a reference.Methods: Fifty-six subjects with cardiac disease or suspected cardiac disease, underwent both late iodine enhancement on CT (CT-LIE) scanning and late gadolinium enhancement on MRI (MRI-LGE) scanning.Each procedure occurred within a week of the other. Global and segmental ECVs of the left ventricle were measured by CT and MRI images. According to the location and pattern of delayed enhancement on MRI image, myocardial segments were classified into 3 groups: ischemic LGE segments (group 1), nonischemicLGE segments (group 2) and negative LGE segments (group 3). The correlation and agreement between CT-ECV and MRI-ECV were compared on a per-segment basis. Receiver operating characteristic (ROC) curve analysis was performed to establish a threshold for LIE detection.Results: Among the 56 patients, 896 segments were analyzed, and of these, 73 segments were in group 1, 229 segments were in group 2, and 594 segments were in group 3. In segmental analysis, CT-ECV in group 3 (27.0%; 24.9-28.9%) was significantly lower than that in group 1 (33.2%; 30.7-36.3%) and group 2 (34.9%; 32.3-39.8%; all P<0.001). Good correlations were seen between CT-ECV and MRI-ECV for all groups (group 1: r=0.920; group 2: r=0.936; group 3: r=0.799; all P<0.001). Bland-Altman analysis between CT-ECV and MRI-ECV showed a small bias in all 3 groups (group 1: -2.1%, 95% limits of agreement −11.3-7.1%; group 2: −0.6%, 95% limits of agreement −13.1-11.9%; group 3: 1.0%, 95% limits of agreement −12.7-14.7%). CT-ECV could differentiate between LGE-positive and LGE-negative segments with 83.1% sensitivity and 93.3% specificity at a cutoff of 31%.Conclusions: ECV values derived from CT imaging showed good correlation and agreement with MR imaging findings, and CT-ECV provided high diagnostic accuracy for discriminating between LGE-positive and LGE-negative segments. Thus, cardiac CT imaging might be a suitable noninvasive imaging technique for myocardial ECV quantification. 2 Liu et al. Quantitative analysis of myocardium using dual-layer SDCT

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Myocardial Extracellular Volume Is Not Associated With Malignant Ventricular Arrhythmias in High-risk Hypertrophic Cardiomyopathy

Cited by 2 publications

References 44 publications

The Relationship between Cardiac Magnetic Resonance-Assessed Replacement and Interstitial Fibrosis and Ventricular Arrhythmias in Hypertrophic Cardiomyopathy

The Relationship between Cardiac Magnetic Resonance-Assessed Replacement and Interstitial Fibrosis and Ventricular Arrhythmias in Hypertrophic Cardiomyopathy

Quantitative analysis of late iodine enhancement using dual-layer spectral detector computed tomography: comparison with magnetic resonance imaging

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