TY - JOUR
T1 - Local Conduction Velocity in the Presence of Late Gadolinium Enhancement and Myocardial Wall Thinning
T2 - A Cardiac Magnetic Resonance Study in a Swine Model of Healed Left Ventricular Infarction
AU - Jang, Jihye
AU - Whitaker, John
AU - Leshem, Eran
AU - Ngo, Long H.
AU - Neisius, Ulf
AU - Nakamori, Shiro
AU - Pashakhanloo, Farhad
AU - Menze, Bjoern
AU - Manning, Warren J.
AU - Anter, Elad
AU - Nezafat, Reza
N1 - Publisher Copyright:
© 2019 American Heart Association, Inc.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Background: Conduction velocity (CV) is an important property that contributes to the arrhythmogenicity of the tissue substrate. The aim of this study was to investigate the association between local CV versus late gadolinium enhancement (LGE) and myocardial wall thickness in a swine model of healed left ventricular infarction. Methods: Six swine with healed myocardial infarction underwent cardiovascular magnetic resonance imaging and electroanatomic mapping. Two healthy controls (one treated with amiodarone and one unmedicated) underwent electroanatomic mapping with identical protocols to establish the baseline CV. CV was estimated using a triangulation technique. LGE+ regions were defined as signal intensity >2 SD than the mean of remote regions, wall thinning+ as those with wall thickness <2 SD than the mean of remote regions. LGE heterogeneity was defined as SD of LGE in the local neighborhood of 5 mm and wall thickness gradient as SD within 5 mm. Cardiovascular magnetic resonance and electroanatomic mapping data were registered, and hierarchical modeling was performed to estimate the mean difference of CV (LGE+/-, wall thinning+/-), or the change of the mean of CV per unit change (LGE heterogeneity, wall thickness gradient). Results: Significantly slower CV was observed in LGE+ (0.33±0.25 versus 0.54±0.36 m/s; P<0.001) and wall thinning+ regions (0.38±0.28 versus 0.55±0.37 m/s; P<0.001). Areas with greater LGE heterogeneity (P<0.001) and wall thickness gradient (P<0.001) exhibited slower CV. Conclusions: Slower CV is observed in the presence of LGE, myocardial wall thinning, high LGE heterogeneity, and a high wall thickness gradient. Cardiovascular magnetic resonance may offer a valuable imaging surrogate for estimating CV, which may support noninvasive identification of the arrhythmogenic substrate. Visual Overview: A visual overview is available for this article.
AB - Background: Conduction velocity (CV) is an important property that contributes to the arrhythmogenicity of the tissue substrate. The aim of this study was to investigate the association between local CV versus late gadolinium enhancement (LGE) and myocardial wall thickness in a swine model of healed left ventricular infarction. Methods: Six swine with healed myocardial infarction underwent cardiovascular magnetic resonance imaging and electroanatomic mapping. Two healthy controls (one treated with amiodarone and one unmedicated) underwent electroanatomic mapping with identical protocols to establish the baseline CV. CV was estimated using a triangulation technique. LGE+ regions were defined as signal intensity >2 SD than the mean of remote regions, wall thinning+ as those with wall thickness <2 SD than the mean of remote regions. LGE heterogeneity was defined as SD of LGE in the local neighborhood of 5 mm and wall thickness gradient as SD within 5 mm. Cardiovascular magnetic resonance and electroanatomic mapping data were registered, and hierarchical modeling was performed to estimate the mean difference of CV (LGE+/-, wall thinning+/-), or the change of the mean of CV per unit change (LGE heterogeneity, wall thickness gradient). Results: Significantly slower CV was observed in LGE+ (0.33±0.25 versus 0.54±0.36 m/s; P<0.001) and wall thinning+ regions (0.38±0.28 versus 0.55±0.37 m/s; P<0.001). Areas with greater LGE heterogeneity (P<0.001) and wall thickness gradient (P<0.001) exhibited slower CV. Conclusions: Slower CV is observed in the presence of LGE, myocardial wall thinning, high LGE heterogeneity, and a high wall thickness gradient. Cardiovascular magnetic resonance may offer a valuable imaging surrogate for estimating CV, which may support noninvasive identification of the arrhythmogenic substrate. Visual Overview: A visual overview is available for this article.
KW - conduction velocity
KW - electroanatomic mapping
KW - late gadolinium enhancement
KW - magnetic resonance imaging
KW - myocardial infarction
KW - myocardial wall thickness
KW - ventricular tachycardia
UR - http://www.scopus.com/inward/record.url?scp=85065070405&partnerID=8YFLogxK
U2 - 10.1161/CIRCEP.119.007175
DO - 10.1161/CIRCEP.119.007175
M3 - Article
C2 - 31006313
AN - SCOPUS:85065070405
SN - 1941-3149
VL - 12
JO - Circulation: Arrhythmia and Electrophysiology
JF - Circulation: Arrhythmia and Electrophysiology
IS - 5
M1 - e007175
ER -
