TY - JOUR
T1 - Delayed enhancement cardiac magnetic resonance imaging can identify the risk for ventricular tachycardia in chagas' cardiomyopathy
AU - de Mello, Ronaldo Peixoto
AU - Szarf, Gilberto
AU - Schvartzman, Paulo Roberto
AU - Nakano, Edson Minoru
AU - Espinosa, Mariano Martinez
AU - Szejnfeld, Denis
AU - Fernandes, Verônica
AU - Lima, João A.C.
AU - Cirenza, Claudio
AU - De Paola, Angelo A.V.
PY - 2012/5
Y1 - 2012/5
N2 - Background: Invasive and non-invasive tests have been used to identify the risk of ventricular tachycardia (VT) in patients with chagas' cardiomyopathy (CCM). Cardiac magnetic resonance imaging (CMRI) using the delayed enhancement (DE) technique can be useful to select patients with global or segmentary ventricular dysfunction, with high degree of fibrosis and at higher risk for clinical VT. Objective: To improve the identification of predictors of VT in patients with CCM. Methods: This study assessed 41 patients with CCM [30 (72%) males; mean age, 55.1 ± 11.9 years]. Twenty-six patients had history of VT (VT group), and 15 had no VT (NVT group). All patients enrolled had DE and segmentary ventricular dysfunction. In each case, the following variables were determined: left ventricular volume; percentage of ventricular wall thickness impairment in each segment; and DE distribution. Results: No statistical difference regarding the DE volume between both groups was observed: VT group = 30.0 ± 16.2%; NVT group = 21.7 ± 15.7%; p = 0.118. The probability of VT was greater in the presence of two or more contiguous transmural fibrosis areas, and that was a predictive factor of clinical VT (RR 4.1; p = 0,04). Agreement between observers was 100% regarding that criterion (p < 0.001). Conclusion: The identification of two or more segments of transmural DE by use of CMRI is associated with the occurrence of clinical VT in patients with CCM. Thus, CMRI improved risk stratification in the population studied.
AB - Background: Invasive and non-invasive tests have been used to identify the risk of ventricular tachycardia (VT) in patients with chagas' cardiomyopathy (CCM). Cardiac magnetic resonance imaging (CMRI) using the delayed enhancement (DE) technique can be useful to select patients with global or segmentary ventricular dysfunction, with high degree of fibrosis and at higher risk for clinical VT. Objective: To improve the identification of predictors of VT in patients with CCM. Methods: This study assessed 41 patients with CCM [30 (72%) males; mean age, 55.1 ± 11.9 years]. Twenty-six patients had history of VT (VT group), and 15 had no VT (NVT group). All patients enrolled had DE and segmentary ventricular dysfunction. In each case, the following variables were determined: left ventricular volume; percentage of ventricular wall thickness impairment in each segment; and DE distribution. Results: No statistical difference regarding the DE volume between both groups was observed: VT group = 30.0 ± 16.2%; NVT group = 21.7 ± 15.7%; p = 0.118. The probability of VT was greater in the presence of two or more contiguous transmural fibrosis areas, and that was a predictive factor of clinical VT (RR 4.1; p = 0,04). Agreement between observers was 100% regarding that criterion (p < 0.001). Conclusion: The identification of two or more segments of transmural DE by use of CMRI is associated with the occurrence of clinical VT in patients with CCM. Thus, CMRI improved risk stratification in the population studied.
KW - Cardiac magnetic resonance imaging
KW - Chagas' cardiomyopathy
KW - Tachycardia ventricular
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U2 - 10.1590/S0066-782X2012005000031
DO - 10.1590/S0066-782X2012005000031
M3 - Article
C2 - 22460166
AN - SCOPUS:84866038914
SN - 0066-782X
VL - 98
SP - 421
EP - 430
JO - Arquivos brasileiros de cardiologia
JF - Arquivos brasileiros de cardiologia
IS - 5
ER -