Evaluation of techniques for the quantification of myocardial scar of differing etiology using cardiac magnetic resonance
Andrew S. Flett,Jonathan Hasleton,Christopher Cook,Derek J. Hausenloy,Giovanni Quarta,Giovanni Quarta,Cono Ariti,Vivek Muthurangu,James C. Moon +8 more
TLDR
Regardless of the disease under study, the FWHM technique for LGE quantification gives LGE volume mean results similar to manual quantification and is statistically the most reproducible, reducing required sample sizes by up to one-half.Abstract:
Objectives The aim of this study was to compare the reproducibility of 7 late gadolinium enhancement (LGE) quantification techniques across 3 conditions in which LGE is known to be important: acute myocardial infarction (AMI), chronic myocardial infarction (CMI), and hypertrophic cardiomyopathy (HCM) Background LGE by cardiac magnetic resonance is the gold-standard technique for assessing myocardial scar No consensus exists on the best method for its quantification, and research in this area is scant Techniques include manual quantification, thresholding by 2, 3, 4, 5, or 6 SDs above remote myocardium, and the full width at half maximum (FWHM) technique To date, LGE has been linked to outcome in 3 conditions: AMI, CMI, and HCM Methods Sixty patients with 3 LGE etiologies (AMI, n = 20; CMI, n = 20; HCM, n = 20) were scanned for LGE LGE volume was quantified using the 7 techniques Mean LGE volume, interobserver and intraobserver reproducibility, and impact on sample size were assessed Results LGE volume varied significantly with the quantification method used There was no statistically significant difference between LGE volume by the FWHM, manual, and 6-SD or 5-SD techniques The 2-SD technique generated LGE volumes up to 2 times higher than the FWHM, 6-SD, and manual techniques The reproducibility of all techniques was worse in HCM than AMI or CMI The FWHM technique was the most reproducible in all 3 conditions compared with any other method (p Conclusions Regardless of the disease under study, the FWHM technique for LGE quantification gives LGE volume mean results similar to manual quantification and is statistically the most reproducible, reducing required sample sizes by up to one-halfread more
Citations
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Relation between left atrial wall composition by late gadolinium enhancement and complex fractionated atrial electrograms in patients with persistent atrial fibrillation: influence of non-fibrotic substrate in the left atrium.
TL;DR: The evaluation of LA wall normal substrate by LGE-CMR might be useful to predict the CFAE occurrence before catheter ablation of PeAF.
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Hemodynamic determinants of left atrial strain in patients with hypertrophic cardiomyopathy: A combined echocardiography and CMR study
TL;DR: In this paper, the authors examined the relationship of the left atrial (LA) strain with exercise tolerance and clinical events in patients with hypertrophic cardiomyopathy (HCM) using echocardiographic and CMR imaging.
Journal ArticleDOI
Incidence of Sudden Cardiac Death and Life-Threatening Arrhythmias in Clinically Manifest Cardiac Sarcoidosis With and Without Current Indications for an Implantable Cardioverter Defibrillator
Hanna-Kaisa Nordenswan,Pauli Pöyhönen,Jukka Y. A. Lehtonen,Kaj Ekström,Valtteri Uusitalo,Meri Niemelä,Tapani Vihinen,Kari S. Kaikkonen,Petri Haataja,Tuomas Kerola,Tuomas T. Rissanen,Aleksi Alatalo,Päivi Pietilä-Effati,Markku Kupari +13 more
TL;DR: Current ICD guidelines fail to distinguish a truly low-risk group of patients with clinically manifest CS, the 5-year risk of SCD approaching 5% despite absent ICD indications, and all patients with CS presenting with clinical cardiac manifestations should be considered for an ICD implantation.
Journal ArticleDOI
EVCMR: A tool for the quantitative evaluation and visualization of cardiac MRI data
TL;DR: The custom tool has the potential to provide a fast and comprehensive analysis of the LV and myocardium from multi-parametric MRI data in clinical settings and enabled fast user interactions in rotating and zooming-in/out of the 3D myocardia and scar transmurality.
Journal ArticleDOI
Sudden Cardiac Death in Ischemic Heart Disease: From Imaging Arrhythmogenic Substrate to Guiding Therapies
TL;DR: The current evidence of SCD relating to ischemic heart disease is reviewed, insights into imaging of the arrhythmogenic substrate that produces lethal ventricular arrhythmia are provided, and how imaging may guide therapies toward SCD prevention are discussed.
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