Predicting postinfarct ventricular tachycardia by integrating cardiac MRI and advanced computational reentrant pathway analysis
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Le résumé fourni par la source
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.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Predicting postinfarct ventricular tachycardia by integrating cardiac MRI and advanced computational reentrant pathway analysis
- Date Crossref
- 01/10/2024
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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King's College London pays non établi dans la noticeUniversité ou école supérieure
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Amsterdam University Medical Centers Department of Cardiology pays non établi dans la noticeÉtablissement de santé
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Royal Brompton & Harefield NHS Foundation Trust Department of Cardiology pays non établi dans la noticeÉtablissement de santé
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St Thomas' Hospital pays non établi dans la noticeÉtablissement de santé
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Medical University of Graz Gottfried Schatz Research Center pays non établi dans la noticeUniversité ou école supérieure
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School of Biomedical Engineering and Imaging Sciences pays non établi dans la noticeUniversité ou école supérieure
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St. Thomas' Hospital Department of Cardiology pays non établi dans la noticeÉtablissement de santé
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NumeriCor GmbH pays non établi dans la noticeEntreprise
King's College London, Department of Cardiology — Amsterdam University Medical Centers et Department of Cardiology — Royal Brompton & Harefield NHS Foundation Trust, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.