Scar channels in cardiac magnetic resonance to predict appropriate therapies in primary prevention

Sánchez-Somonte, Paula; Quinto, Levio; Garre, Paz; Zaraket, Fátima; Alarcón, Francisco; Borràs, Roger; Caixal, Gala; Vázquez, Sara; Prat, Susanna Soler; Ortiz-Pérez, Josè T.; Perea, Rosario J.; Guasch, Eduard; Tolosana, José Marı́a; Berruezo, Antonio; Arbelo, Elena; Sitges, Marta; Mont, Lluís; Roca‐Luque, Ivo

doi:10.1016/j.hrthm.2021.04.017

Cited by 36 publications

(31 citation statements)

References 19 publications

(18 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, we acknowledge that newer indices derived from cardiac magnetic resonance imaging have recently been reported. 19 Our study consists of a relatively small number of patients, and larger prospective studies are needed to assess the role of CE-CT for risk stratification in ICM patients. Histopathology was not available for all patients; nevertheless, available samples provide insight into what LV tissue heterogeneity on CE-CT represents at the histopathologic level.…”

Section: Discussionmentioning

confidence: 99%

Association of left ventricular tissue heterogeneity and intramyocardial fat on computed tomography with ventricular arrhythmias in ischemic cardiomyopathy

et al. 2022

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Association of left ventricular tissue heterogeneity and intramyocardial fat on computed tomography with ventricular arrhythmias in ischemic cardiomyopathy

et al. 2022

View full text Add to dashboard Cite

“…Infarct size assessed by LGE-CMR is an independent predictor of arrhythmic events ( 53 ). However, in a recent study by our group ( 54 ) we prospectively analysed 200 patients (mainly ischemic patients) with primary prevention ICD indication (LVEF <35%), and despite 83% of them having undergone LGE-CMR, only 20% of them had ICD-appropriate therapies in long-term follow-up. In this sense, a more detailed analysis of LGE-CMR images assessing the amount of scar, BZ, and the presence of channels can improve risk stratification.…”

Section: Clinical Applications Of Lge-cmr In Vt Ablationmentioning

confidence: 99%

“… Adapted from Sánchez-Somonte et al ( 54 ). (A) Late gadolinium enhancement-cardiac magnetic resonance (LGE-CMR) reconstruction of the left ventricle (LV) with a posteroseptal scar (core in red, BZ in white, and healthy myocardium in blue).…”

Section: Clinical Applications Of Lge-cmr In Vt Ablationmentioning

confidence: 99%

See 1 more Smart Citation

Cardiac Magnetic Resonance for Ventricular Tachycardia Ablation and Risk Stratification

Roca‐Luque

Mont-Girbau

2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Ventricular tachycardia is the most frequent cause of sudden cardiovascular death in patients with structural heart disease. Radiofrequency ablation is the treatment cornerstone in this population. Main mechanism for structural heart disease-related ventricular tachycardia is re-entry due to presence of slow conduction area within the scar tissue. Electroanatomical mapping with high density catheters can elucidate the presence of both scar (voltage maps) and slow conduction (activation maps). Despite the technological improvements recurrence rate after ventricular tachycardia ablation is high. Cardiac magnetic resonance has demonstrated to be useful to define the location of the scar tissue in endocardium, midmyocardium and/or epicardial region. Furthermore, recent studies have shown that cardiac magnetic resonance can analyse in detail the ventricular tachycardia substrate in terms of core scar and border zone tissue. This detailed tissue analysis has been proved to have good correlation with slow conduction areas and ventricular tachycardia isthmuses in electroanatomical maps. This review will provide a summary of the current role of cardiac magnetic resonance in different scenarios related with ventricular tachycardia in patients with structural heart disease, its limitations and the future perspectives.

show abstract

“…A mechanistically-minded approach in LGE has been identifying conducting channels, a nidus for VT as identified in CAD ( 29 ). A study in a mixed ICM/NICM population showed that the presence and mass of these channels were associated with the risk of VA and appropriate primary prevention ICD therapy ( 30 ).…”

Section: Cardiac Magnetic Resonance Imagingmentioning

confidence: 99%

Advanced imaging for risk stratification for ventricular arrhythmias and sudden cardiac death

Xie

Sung

Saad

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Sudden cardiac death (SCD) is a leading cause of mortality, comprising approximately half of all deaths from cardiovascular disease. In the US, the majority of SCD (85%) occurs in patients with ischemic cardiomyopathy (ICM) and a subset in patients with non-ischemic cardiomyopathy (NICM), who tend to be younger and whose risk of mortality is less clearly delineated than in ischemic cardiomyopathies. The conventional means of SCD risk stratification has been the determination of the ejection fraction (EF), typically via echocardiography, which is currently a means of determining candidacy for primary prevention in the form of implantable cardiac defibrillators (ICDs). Advanced cardiac imaging methods such as cardiac magnetic resonance imaging (CMR), single-photon emission computerized tomography (SPECT) and positron emission tomography (PET), and computed tomography (CT) have emerged as promising and non-invasive means of risk stratification for sudden death through their characterization of the underlying myocardial substrate that predisposes to SCD. Late gadolinium enhancement (LGE) on CMR detects myocardial scar, which can inform ICD decision-making. Overall scar burden, region-specific scar burden, and scar heterogeneity have all been studied in risk stratification. PET and SPECT are nuclear methods that determine myocardial viability and innervation, as well as inflammation. CT can be used for assessment of myocardial fat and its association with reentrant circuits. Emerging methodologies include the development of “virtual hearts” using complex electrophysiologic modeling derived from CMR to attempt to predict arrhythmic susceptibility. Recent developments have paired novel machine learning (ML) algorithms with established imaging techniques to improve predictive performance. The use of advanced imaging to augment risk stratification for sudden death is increasingly well-established and may soon have an expanded role in clinical decision-making. ML could help shift this paradigm further by advancing variable discovery and data analysis.

show abstract

Scar channels in cardiac magnetic resonance to predict appropriate therapies in primary prevention

Cited by 36 publications

References 19 publications

Association of left ventricular tissue heterogeneity and intramyocardial fat on computed tomography with ventricular arrhythmias in ischemic cardiomyopathy

Association of left ventricular tissue heterogeneity and intramyocardial fat on computed tomography with ventricular arrhythmias in ischemic cardiomyopathy

Cardiac Magnetic Resonance for Ventricular Tachycardia Ablation and Risk Stratification

Advanced imaging for risk stratification for ventricular arrhythmias and sudden cardiac death

Contact Info

Product

Resources

About