Golcuk Ebru, Yalin Kivanc, Aksu Tolga, Tiryakioglu Selma Kenar, Bilge Ahmet Kaya, Adalet Kamil
Department of Cardiology, Bayrampasa Kolan Hospital, Istanbul, Turkey.
Cardiology Clinic, Bayrampasa Kolan Hospital, Istanbul, Turkey.
Am J Med Sci. 2016 May;351(5):452-8. doi: 10.1016/j.amjms.2016.01.014. Epub 2016 Jan 29.
The role of contrast-enhanced (ce) cardiac magnetic resonance in risk stratification of patients with depressed left ventricle (LV) function is widely studied. In this study, we investigated the myocardial infarct size and characteristics by ce-magnetic resonance imaging (MRI) and its relationship with spontaneous ventricular arrhythmia occurrence during follow-up of in patients with mild LV systolic dysfunction and nonsustained ventricular tachycardia (VT).
This study enrolled 32 patients with postmyocardial infarction with an LV ejection fraction between 40% and 50% and nonsustained VT. Cardiac MRI performed to identify cardiac scar size and characteristics. Dense scar, peri-infarction zone and total infarct masses were calculated, these values to LV mass ratios were obtained. All patients were followed up 48 ± 6 months. Cardiac magnetic resonance data compared among patients with (n = 6) and without spontaneous sustained VT (n = 26).
During follow-up, 6 patients experienced sustained VT (VT+ group), whereas 26 patients had no sustained ventricular arrhythmia (VT- group). The groups had similar baseline clinical characteristics. The LV masses, volumes and ejection fractions did not differ significantly between 2 groups. For the VT+ group versus VT- group dense scar to LV mass were similar (3.1 ± 0.3% versus 3.3 ± 0.9%, P = not significant). Ratio of peri-infarction zone to LV mass (30.9 ± 6.1% versus 21.3 ± 7.5%, P = 0.007) and total infarct to LV mass (34.1 ± 6.1% versus 24.6 ± 7.9%, P = 0.011) were larger in patients with sustained VT.
This small study supports the potential utility of ce-MRI to identify patients with postmyocardial infarction prone to develop serious ventricular arrhythmias.
对比增强（ce）心脏磁共振成像在左心室（LV）功能不全患者风险分层中的作用已得到广泛研究。在本研究中，我们通过ce磁共振成像（MRI）研究了心肌梗死面积和特征，及其与轻度LV收缩功能不全和非持续性室性心动过速（VT）患者随访期间自发性室性心律失常发生的关系。
本研究纳入了32例心肌梗死后左心室射血分数在40%至50%之间且有非持续性VT的患者。进行心脏MRI以确定心脏瘢痕面积和特征。计算致密瘢痕、梗死周边区和总梗死质量，并获得这些值与左心室质量的比值。所有患者随访48±6个月。比较发生（n = 6）和未发生（n = 26）自发性持续性VT患者的心脏磁共振数据。
随访期间，6例患者发生持续性VT（VT+组），而26例患者无持续性室性心律失常（VT-组）。两组基线临床特征相似。两组间左心室质量、容积和射血分数无显著差异。VT+组与VT-组相比，致密瘢痕与左心室质量相似（3.1±0.3%对3.3±0.9%，P = 无显著性差异）。持续性VT患者梗死周边区与左心室质量的比值（30.9±6.1%对21.3±7.5%，P = 0.007）和总梗死与左心室质量的比值（34.1±6.1%对24.6±7.9%，P = 0.011）更大。
这项小型研究支持ce-MRI在识别心肌梗死后易发生严重室性心律失常患者方面的潜在效用。
