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首页> 外文期刊>European heart journal cardiovascular Imaging >Myocardial infarct heterogeneity assessment by late gadolinium enhancement cardiovascular magnetic resonance imaging shows predictive value for ventricular arrhythmia development after acute myocardial infarction
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Myocardial infarct heterogeneity assessment by late gadolinium enhancement cardiovascular magnetic resonance imaging shows predictive value for ventricular arrhythmia development after acute myocardial infarction

机译：晚期g增强心血管磁共振成像对心肌梗死的异质性评估显示对急性心肌梗死后室性心律失常发展的预测价值

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The aim of this study was to assess the association between the proportions of penumbra-visualized by late gadolinium enhanced cardiovascular magnetic resonance imaging (LGE-CMR)-after acute myocardial infarction (AMI) and the prevalence of ventricular tachycardia (VT).One-hundred and sixty-two AMI patients, successfully, treated by primary percutaneous coronary intervention (PCI) underwent LGE-CMR after a median of 3 days (3-4) and 24-h Holter monitoring after 1 month. With LGE-CMR, the total amount of enhanced myocardium was quantified and divided into an infarct core (>50% of maximal signal intensity) and penumbra (25—50% of maximal signal intensity). With Holter monitoring, the number of VTs (>4 successive PVCs) per 24 h was measured.The mean total enhanced myocardium was 31 ±11% of the left ventricular mass. The % penumbra accounted for 39 ±11% of the total enhanced area. In 29 (18%) patients, Holter monitoring showed VT, with a median of 1 episode (1-3) in. 24 h. A larger proportion of penumbra within the enhanced area increased the risk of VTs [OR: 1.06 (95% Cl: 1.02-1.10), P = 0.003]. After multivariate logistic regression analysis, the presence of ventricular fibrillation before primary PCI [OR: 5.60 (95% Cl: 1.54=20.29), P = 0.01] and the proportional amount of penumbra within the enhanced myocardium [OR: 1.06 (95% Cl: 1.02-1.10), P = 0.04] were independently associated with VT on Holter monitoring.Larger proportions of penumbra in the subacute phase after AMI are associated with increased risk of developing VTs. Quantification of penumbra size may become a usefulfuture tool for risk stratification and ultimately for the prevention of ventricular arrhythmias.
机译：这项研究的目的是评估急性心肌梗死（AMI）后晚期g增强心血管磁共振成像（LGE-CMR）所显示的半影比例与室性心动过速（VT）的患病率之间的关联。经中位3天（3-4）和1个月后24小时动态心电图监测，通过原发性经皮冠状动脉介入治疗（PCI）成功治疗的162例AMI患者接受了LGE-CMR。使用LGE-CMR，可以量化增强心肌的总量，并将其分为梗死核心（最大信号强度的> 50％）和半影（最大信号强度的25-50％）。通过动态心电图监测，每24小时测量一次VT（> 4个连续PVC）的数量，平均总增强心肌面积为左心室质量的31±11％。半影的百分比占总增强区域的39±11％。在29名（18％）患者中，动态心电图监测显示为室速，中位值为24小时1次发作（1-3）。在增强区域内较大的半影增加了VT的风险[OR：1.06（95％Cl：1.02-1.10），P = 0.003]。经过多因素logistic回归分析后，在原发性PCI之前存在心室纤颤[OR：5.60（95％Cl：1.54 = 20.29），P = 0.01]和增强的心肌内半影的比例[OR：1.06（95％Cl ：1.02-1.10），P = 0.04]与Holter监测中的室速独立相关。AMI后亚急性期半影的比例较高与室速发生的风险增加有关。半影大小的量化可能成为风险分层以及最终预防室性心律失常的有用工具。

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