Karaayvaz Ekrem Bilal, Engin Berat, Yalin Kivanc, Ozer Pelin Karaca, Baykiz Derya, Bilge Ahmet Kaya
Department of Cardiology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
Manavgat State Hospital, Antalya, Turkey.
Pacing Clin Electrophysiol. 2021 Jun;44(6):1010-1017. doi: 10.1111/pace.14257. Epub 2021 May 21.
Ventricular scars due to myocardial infarction provide a substrate for ventricular arrhythmias, and cardiac magnetic resonance (CMR) is the golden standard for the quantification of scar tissue magnitude. CMR has still limitations with patients with ICD despite ICD's becoming MR-compatible. We investigated the association between calibrated integrated backscatter (cIBS) and arrhythmia frequency in patients with ICD.
Thirty-two ischemic dilated cardiomyopathy (ICM) patients with VVI-ICD (mean age 66.56 ± 9.05, 28 male, and four female) were divided into three groups according to their arrhythmia frequency (ventricular arrhythmia-[VA -], VA + [VA +], and arrhythmia storm [AS]). Then with transthoracic echocardiography (TTE), all patients' cIBS values were calculated and these values were compared with the patients' arrhythmia frequency.
cIBS values of patients with VA + and AS were significantly higher in the apical-septal (0.66 ± 0.11 vs. 0.50 ± 0.16, p = .008) and apical-lateral (0.62 ± 0.19 vs. 0.46 ± 0.18, p = .041) segments compared to those of patients with VA -. The cIBS values of apical-septal (0.50 ± 0.16 vs. 0.65 ± 0.08 vs. 0.66 ± 0.13 respectively, p = .032) and apical-anterior (0.53 ± 0.22 vs. 0.48 ± 0.17 vs. 0.79 ± 0.23 respectively, p = .03) segments were significantly different between the groups. Furthermore, in the post hoc analysis, the difference was significantly higher in VA + than VA - in the apical-septal segment and higher in AS than VA + in apical-anterior segments.
Our findings suggest an association between the cIBS values and arrhythmia frequency in the study group.
心肌梗死所致的心室瘢痕为室性心律失常提供了基质，心脏磁共振成像（CMR）是量化瘢痕组织大小的金标准。尽管植入式心律转复除颤器（ICD）已具备磁共振兼容性，但CMR在ICD患者中仍存在局限性。我们研究了校准后向散射积分（cIBS）与ICD患者心律失常频率之间的关联。
32例VVI-ICD的缺血性扩张型心肌病（ICM）患者（平均年龄66.56±9.05岁，男性28例，女性4例）根据心律失常频率分为三组（室性心律失常-[VA-]、VA+[VA+]和心律失常风暴[AS]）。然后通过经胸超声心动图（TTE）计算所有患者的cIBS值，并将这些值与患者的心律失常频率进行比较。
与VA-组患者相比，VA+组和AS组患者的心尖-间隔段（0.66±0.11对0.50±0.16，p=0.008）和心尖-侧壁段（0.62±0.19对0.46±0.18，p=0.041）的cIBS值显著更高。心尖-间隔段（分别为0.50±0.16对0.65±0.08对0.66±0.13，p=0.032）和心尖-前壁段（分别为0.53±0.22对0.48±0.17对0.79±0.23，p=0.03）的cIBS值在三组之间存在显著差异。此外，在事后分析中，心尖-间隔段VA+组与VA-组的差异显著高于VA-组，心尖-前壁段AS组高于VA+组。
我们的研究结果表明，研究组中cIBS值与心律失常频率之间存在关联。
