Validation of sub‐segmental visual scoring for the quantification of ischemic and nonischemic myocardial fibrosis using late gadolinium enhancement MRI

Fine, Nowell M.; Tandon, Shruti; Kim, Han W.; Shah, Dipan J.; Thompson, Terry; Drangova, Maria; White, James A.

doi:10.1002/jmri.24116

Cited by 35 publications

(21 citation statements)

References 33 publications

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“…Degree of MF was determined on DCE-CMR with visual sub-segmental analysis (VSSA)-based quantification [ 13 ]. This approach estimates the percent of transmural extent of the myocardial-delayed hyperenhancement for each of the 17 segments according to the AHA recommendations [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

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Differences in Aortic Valve and Left Ventricular Parameters Related to the Severity of Myocardial Fibrosis in Patients with Severe Aortic Valve Stenosis

Song

et al. 2017

PLoS ONE

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ObjectiveThis study investigated the morphological and functional characteristics of the aortic valve and the left ventricular (LV) systolic functional parameters and myocardial mass related to the severity of myocardial fibrosis (MF) in patients with severe aortic valve stenosis (AS).Materials and MethodsWe retrospectively enrolled 81 patients (48 men; mean age: 59±12 years) with severe AS who underwent transthoracic echocardiography (TTE), cardiac computed tomography (CCT), and cardiovascular magnetic resonance (CMR) within 1 month and subsequent aortic valve surgery. Degree of MF was determined on delayed contrast-enhanced CMR with visual sub-segmental analysis-based quantification and was classified into three groups (no, mild, and severe) for identifying the differences in LV function and characteristics of the aortic valve. One-way ANOVA, Chi-square test or Fisher’s exact test were used to compare variables of the three groups. Univariate multinomial logistic regression analysis was performed to determine the association between the severity of MF and variables on imaging modalities.ResultsOf 81 patients, 34 (42%) had MF (mild, n = 18; severe, n = 16). Aortic valve calcium volume score on CCT, aortic valve area, LV mass index, LV end-diastolic volume index on CMR, presence of mild aortic regurgitation (AR), transaortic mean pressure gradient, and peak velocity on TTE were significantly different among the three groups and were associated with severity of MF on a univariate multinomial logistic regression analysis. Aortic valve calcium grade was different (p = 0.008) among the three groups but not associated with severity of MF (p = 0.375).ConclusionsA multi-imaging approach shows that severe AS with MF is significantly associated with more severe calcific AS, higher LV end-diastolic volume, higher LV mass, and higher prevalence of mild AR.

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Section: Methodsmentioning

confidence: 99%

“…A score ranging from 0 to 4 was attributed to all of the segments according to the depth of MF: score 0 = 0%, 1 = 1–25%, 2 = 26–50%, 3 = 51–75% and 4 = 76–100% ( Fig 2 ). All 17 scores were summed and multiplied by 1.47% for calculating total percent LV MF volume [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

Differences in Aortic Valve and Left Ventricular Parameters Related to the Severity of Myocardial Fibrosis in Patients with Severe Aortic Valve Stenosis

Song

et al. 2017

PLoS ONE

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“…LGE was quantified using a visual subsegmental analysis [11] and expressed as the total percentage of left ventricular scar volume.…”

Section: Ecg and Cmr Analysismentioning

confidence: 99%

Early Repolarization Pattern and Left Ventricular Mass in Hypertrophic Cardiomyopathy

et al. 2020

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Background: J-point elevation in the inferior and/or lateral leads is associated with an increased incidence of sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM), although the exact underlying mechanism is not known. As severe left ventricular hypertrophy and late gadolinium enhancement (LGE) are important risk factors for SCD in this population, we aimed to assess whether there was an association between an early repolarization pattern (ERP) and greater left ventricular mass (LVM) and LGE extent among patients with HCM. Methods: This was a retrospective cohort study of 85 consecutive patients with HCM who underwent cardiac magnetic resonance (CMR) and had an electrocardiogram without confounders (intraventricular conduction delay, complete left or right bundle branch block, or ventricular paced rhythm). Baseline characteristics and MRI-derived LVM and LGE extent were compared between patients with and without ERP. Results: ERP was present in 9 out of 85 patients (10.6%). Patients with ERP had greater indexed LVM compared to those without (112.5 ± 26.3 vs. 87.8 ± 24.6 g/m 2 , p = 0.006). Logistic regression analysis revealed a 4.2fold increase in the odds of prevalent ERP per standard deviation increase in body surface area-indexed LVM (odds ratio 4.2; 95% CI 1.54-11.4, p = 0.005). There were no statistically significant differences regarding LGE extent between groups. Conclusion: ERP is associated with greater CMR-derived LVM among patients with HCM. This finding could partially explain the association between J waves and a higher risk of SCD in this population. There were no differences in LGE extent. Further studies are needed to confirm this association and evaluate the importance of ERP as a marker of increased risk of SCD in HCM.

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“…Non-CAD fibrosis was defined as DE that was not localized in the subendocardium and did not follow a coronary distribution [15]. Fibrosis burden was quantified as percentages using the American Heart Association 17-segments LV model as described previously [16].…”

Section: Cardiac Magnetic Resonance Imaging Acquisition Protocolmentioning

confidence: 99%

Prognostic Value of Delayed Enhancement Cardiac Magnetic Resonance Imaging in Mitral Valve Repair

Chaikriangkrai

Lopez‐Mattei

Lawrie

et al. 2014

The Annals of Thoracic Surgery

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Validation of sub‐segmental visual scoring for the quantification of ischemic and nonischemic myocardial fibrosis using late gadolinium enhancement MRI

Abstract: A VSSA-based model of myocardial scar quantification is accurate and reproducible in ischemic and nonischemic cardiomyopathy.

Cited by 35 publications

References 33 publications

Differences in Aortic Valve and Left Ventricular Parameters Related to the Severity of Myocardial Fibrosis in Patients with Severe Aortic Valve Stenosis

Differences in Aortic Valve and Left Ventricular Parameters Related to the Severity of Myocardial Fibrosis in Patients with Severe Aortic Valve Stenosis

Early Repolarization Pattern and Left Ventricular Mass in Hypertrophic Cardiomyopathy

Prognostic Value of Delayed Enhancement Cardiac Magnetic Resonance Imaging in Mitral Valve Repair

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