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Implications of bipolar voltage mapping and magnetic resonance imaging resolution in biventricular scar characterization after myocardial infarction.
- Source :
-
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2019 Jan 01; Vol. 21 (1), pp. 163-174. - Publication Year :
- 2019
-
Abstract
- Aims: We aimed to study the differences in biventricular scar characterization using bipolar voltage mapping compared with state-of-the-art in vivo delayed gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) imaging and ex vivo T1 mapping.<br />Methods and Results: Ten pigs with established myocardial infarction (MI) underwent in vivo scar characterization using LGE-CMR imaging and high-density voltage mapping of both ventricles using a 3.5-mm tip catheter. Ex vivo post-contrast T1 mapping provided a high-resolution reference. Voltage maps were registered onto the left and right ventricular (LV and RV) endocardium, and epicardium of CMR-based geometries to compare voltage-derived scars with surface-projected 3D scars. Voltage-derived scar tissue of the LV endocardium and the epicardium resembled surface projections of 3D in vivo and ex vivo CMR-derived scars using 1-mm of surface projection distance. The thinner wall of the RV was especially sensitive to lower resolution in vivo LGE-CMR images, in which differences between normalized low bipolar voltage areas and CMR-derived scar areas did not decrease below a median of 8.84% [interquartile range (IQR) (3.58, 12.70%)]. Overall, voltage-derived scars and surface scar projections from in vivo LGE-CMR sequences showed larger normalized scar areas than high-resolution ex vivo images [12.87% (4.59, 27.15%), 18.51% (11.25, 24.61%), and 9.30% (3.84, 19.59%), respectively], despite having used optimized surface projection distances. Importantly, 43.02% (36.54, 48.72%) of voltage-derived scar areas from the LV endocardium were classified as non-enhanced healthy myocardium using ex vivo CMR imaging.<br />Conclusion: In vivo LGE-CMR sequences and high-density voltage mapping using a conventional linear catheter fail to provide accurate characterization of post-MI scar, limiting the specificity of voltage-based strategies and imaging-guided procedures.
- Subjects :
- Animals
Arrhythmias, Cardiac etiology
Arrhythmias, Cardiac physiopathology
Cicatrix etiology
Cicatrix pathology
Cicatrix physiopathology
Contrast Media administration & dosage
Disease Models, Animal
Heart Rate
Male
Meglumine administration & dosage
Myocardial Infarction complications
Myocardial Infarction pathology
Myocardial Infarction physiopathology
Organometallic Compounds administration & dosage
Predictive Value of Tests
Reproducibility of Results
Sus scrofa
Action Potentials
Arrhythmias, Cardiac diagnosis
Cicatrix diagnostic imaging
Electrophysiologic Techniques, Cardiac
Heart Conduction System physiopathology
Magnetic Resonance Imaging
Myocardial Infarction diagnostic imaging
Myocardium pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2092
- Volume :
- 21
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 30239689
- Full Text :
- https://doi.org/10.1093/europace/euy192