Myocardial tissue characterization by cardiac magnetic resonance imaging using T1 mapping predicts ventricular arrhythmia in ischemic and non-ischemic cardiomyopathy patients with implantable cardioverter defibrillators

TY - JOUR

T1 - Myocardial tissue characterization by cardiac magnetic resonance imaging using T1 mapping predicts ventricular arrhythmia in ischemic and non-ischemic cardiomyopathy patients with implantable cardioverter defibrillators

AU - Chen, Zhong

AU - Sohal, Manav

AU - Voigt, Tobias

AU - Sammut, Eva

AU - Tabon-Gomez, Catalina

AU - Child, Nick

AU - Jackson, T.

AU - Shetty, A.

AU - Bostock, Julian

AU - Cooklin, Michael

AU - O'Neil, Mark

AU - Wright, Mark

AU - Murgatroyd, Francis

AU - Gill, Jaswinder

AU - Carr-White, Gerry S.

AU - Chiribiri, Amedeo

AU - Schaeffter, Tobias

AU - Razavi, Reza

AU - Rinaldi, Christopher Aldo

PY - 2015/4/1

Y1 - 2015/4/1

N2 - BackgroundDiffuse myocardial fibrosis may provide substrate for the initiation and maintenance of ventricular arrhythmia. T1 mapping overcomes the limitations of the conventional delayed contrast-enhanced cardiac magnetic resonance imaging (CE-CMR) technique by allowing quantification of diffuse fibrosis. We assessed whether myocardial tissue characterization using T1 mapping would predict ventricular arrhythmia in ischemic and non-ischemic cardiomyopathy.MethodsA prospective longitudinal study of consecutive patients receiving implantable cardioverter defibrillators (ICD) in a tertiary cardiac center. Participants underwent CMR myocardial tissue characterization using T1 mapping and conventional CE-CMR scar assessment prior to device implantation. The primary endpoint was appropriate ICD therapy or documented sustained ventricular arrhythmia.ResultsOne hundred and thirty patients (71 ischemic; 59 non-ischemic) were included with a mean follow-up period of 430±185 days (median: 425 days; IQR: 293 days). At follow-up, 23 (18%) patients experienced the primary endpoint. In multivariable-adjusted analyses, the following factors showed a significant association with the primary endpoint: secondary prevention (hazard ratio [HR] 1.70, confidence interval [CI] 1.01-1.91), non-contrast T1_Native for every 10ms increment in value (HR 1.10, CI 1.04-1.16; 90ms difference between the endpoint positive and negative groups), and grayzone_2sd-3sd for every 1% LV increment in value (HR 1.36, CI 1.15-1.61; 4% difference between the endpoint positive and negative groups). Other CE-CMR indices including scar_2sd, scar_FWHM and grayzone_2sd-FWHM were also significantly, albeit less strongly, associated with the primary endpoint as compared to grayzone_2sd-3sd.ConclusionsQuantitative myocardial tissue assessment using T1 mapping is an independent predictor of ventricular arrhythmia in both ischemic and non-ischemic cardiomyopathies.

AB - BackgroundDiffuse myocardial fibrosis may provide substrate for the initiation and maintenance of ventricular arrhythmia. T1 mapping overcomes the limitations of the conventional delayed contrast-enhanced cardiac magnetic resonance imaging (CE-CMR) technique by allowing quantification of diffuse fibrosis. We assessed whether myocardial tissue characterization using T1 mapping would predict ventricular arrhythmia in ischemic and non-ischemic cardiomyopathy.MethodsA prospective longitudinal study of consecutive patients receiving implantable cardioverter defibrillators (ICD) in a tertiary cardiac center. Participants underwent CMR myocardial tissue characterization using T1 mapping and conventional CE-CMR scar assessment prior to device implantation. The primary endpoint was appropriate ICD therapy or documented sustained ventricular arrhythmia.ResultsOne hundred and thirty patients (71 ischemic; 59 non-ischemic) were included with a mean follow-up period of 430±185 days (median: 425 days; IQR: 293 days). At follow-up, 23 (18%) patients experienced the primary endpoint. In multivariable-adjusted analyses, the following factors showed a significant association with the primary endpoint: secondary prevention (hazard ratio [HR] 1.70, confidence interval [CI] 1.01-1.91), non-contrast T1_Native for every 10ms increment in value (HR 1.10, CI 1.04-1.16; 90ms difference between the endpoint positive and negative groups), and grayzone_2sd-3sd for every 1% LV increment in value (HR 1.36, CI 1.15-1.61; 4% difference between the endpoint positive and negative groups). Other CE-CMR indices including scar_2sd, scar_FWHM and grayzone_2sd-FWHM were also significantly, albeit less strongly, associated with the primary endpoint as compared to grayzone_2sd-3sd.ConclusionsQuantitative myocardial tissue assessment using T1 mapping is an independent predictor of ventricular arrhythmia in both ischemic and non-ischemic cardiomyopathies.

U2 - 10.1016/j.hrthm.2014.12.020

DO - 10.1016/j.hrthm.2014.12.020

M3 - Article

SN - 1556-3871

VL - 12

SP - 792

EP - 801

JO - Heart rhythm : the official journal of the Heart Rhythm Society

JF - Heart rhythm : the official journal of the Heart Rhythm Society

IS - 4

ER -