Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Bhagirath, P; Campos, FO; Zaidi, HA; Chen, Z; Elliott, M; Gould, J; Kemme, MJB; Wilde, AAM; Götte, MJW; Postema, PG; Prassl, AJ; Neic, A; Plank, G; Rinaldi, CA; Bishop, MJ.
Predicting postinfarct ventricular tachycardia by integrating cardiac MRI and advanced computational reentrant pathway analysis.
Heart Rhythm. 2024; 21(10):1962-1969
Doi: 10.1016/j.hrthm.2024.04.077
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- Co-Autor*innen der Med Uni Graz
- Campos Fernando Otaviano
- Neic Aurel-Vasile
- Plank Gernot
- Prassl Anton
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- Abstract:
- BACKGROUND: Implantable cardiac defibrillator (ICD) implantation can protect against sudden cardiac death after myocardial infarction. However, improved risk stratification for device requirement is still needed. OBJECTIVE: The purpose of this study was to improve assessment of postinfarct ventricular electropathology and prediction of appropriate ICD therapy by combining late gadolinium enhancement (LGE) and advanced computational modeling. METHODS: ADAS 3D LV (ADAS LV Medical, Barcelona, Spain) and custom-made software were used to generate 3-dimensional patient-specific ventricular models in a prospective cohort of patients with a myocardial infarction (N = 40) having undergone LGE imaging before ICD implantation. Corridor metrics and 3-dimensional surface features were computed from LGE images. The Virtual Induction and Treatment of Arrhythmias (VITA) framework was applied to patient-specific models to comprehensively probe the vulnerability of the scar substrate to sustaining reentrant circuits. Imaging and VITA metrics, related to the numbers of induced ventricular tachycardias and their corresponding round trip times (RTTs), were compared with ICD therapy during follow-up. RESULTS: Patients with an event (n = 17) had a larger interface between healthy myocardium and scar and higher VITA metrics. Cox regression analysis demonstrated a significant independent association with an event: interface (hazard ratio [HR] 2.79; 95% confidence interval [CI] 1.44-5.44; P < .01), unique ventricular tachycardias (HR 1.67; 95% CI 1.04-2.68; P = .03), mean RTT (HR 2.14; 95% CI 1.11-4.12; P = .02), and maximum RTT (HR 2.13; 95% CI 1.19-3.81; P = .01). CONCLUSION: A detailed quantitative analysis of LGE-based scar maps, combined with advanced computational modeling, can accurately predict ICD therapy and could facilitate the early identification of high-risk patients in addition to left ventricular ejection fraction.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Tachycardia, Ventricular - physiopathology, therapy, etiology, diagnosis
- Male - administration & dosage
- Female - administration & dosage
- Myocardial Infarction - complications, physiopathology
- Middle Aged - administration & dosage
- Magnetic Resonance Imaging, Cine - methods
- Prospective Studies - administration & dosage
- Defibrillators, Implantable - administration & dosage
- Aged - administration & dosage
- Death, Sudden, Cardiac - prevention & control, etiology
- Imaging, Three-Dimensional - administration & dosage
- Risk Assessment - methods
- Heart Ventricles - physiopathology, diagnostic imaging
- Find related publications in this database (Keywords)
- Ischemic cardiomyopathy
- Late gadolinium enhancement
- Ventricular tachycardia
- Computational Modelling
- ICD therapy