Delayed Enhancement on Cardiac MRI Depicts Spatial and Temporal Repolarization Abnormalities in Patients with Lethal Ventricular Arrhythmias
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概要
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<B>Purpose:</B> To elucidate whether the delayed enhancement (DE) distribution on cardiac MRI (CMR) correlates with the rate adaptation pattern and QT/RR diurnal variability in patients with lethal ventricular arrhythmias. <B>Methods:</B> CMR and QT/RR analyses using Holter monitoring were performed in 34 patients (24 males, 59.7±10.5 years) with VT and/or VF. DE on CMR was depicted and the depth was scored as 1 to 4 from the endocardium to epicardium in 17 left ventricular segments. The sum of the scores (Total DE score) was calculated in each patient. The QT/RR slope and day-time/night-time QT/RR ratio (Day/Night ratio) were calculated. The correlation of the slope or Day/Night ratio and DE findings were analyzed. <B>Results:</B> All patients were divided into 23 DE positive (DE(+)) and 11 DE negative (DE(−)) patients. The QT/RR slope was significantly steeper in the DE(+) than DE(−) patients (0.212±0.026 vs. 0.128±0.021 (p<0.001)), and correlated significantly with the Total DE scores (r=0.83 (p<0.001)). The Day/Night ratio was significantly greater in the DE(+) patients than DE(−) patients (1.37±0.38 vs. 0.91±0.33 (p<0.005)). <B>Conclusions:</B> The transmural DE distribution was deeply related to the QT dynamicity pattern in addition to the diurnal QT/RR variability. These results indicate that myocardial scar demonstrated by DE results in increases in the repolarization dispersion in healthy and damaged myocardium, causing severe ventricular arrhythmias in organic heart disease patients.
著者
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Kawamura Yuichiro
Department of Cardiovascular Medicine, Asahikawa Medical College
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Tanabe Yasuko
Department Of Cardiovascular Medicine Asahikawa Medical College
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Sato Nobuyuki
Department Of Applied Physics Fukui University
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Hasebe Naoyuki
Department of Cardiolog, Asahikawa Medical University
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Sakamoto Naka
Department of Cardiology, Asahikawa Medical University
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Talib Ahmed
Department of Cardiology, Asahikawa Medical University
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Nimura Asami
Department of Cardiology, Asahikawa Medical University
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Tanabe Yasuko
Department of Cardiology, Asahikawa Medical University
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Kawamura Yuichiro
Department of Cardiology, Asahikawa Medical University, Japan
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Kawamura Yuichiro
Department of Cardiology, Asahikawa Medical University
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Sato Nobuyuki
Department of Cardiology, Asahikawa Medical University
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