Lipomatous metaplasia prolongs repolarization and increases repolarization dispersion within post-infarct ventricular tachycardia circuit cites.
Lipomatous metaplasia prolongs repolarization and increases repolarization dispersion within post-infarct ventricular tachycardia circuit cites.
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DOI：
10.1093/europace/euac222
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发表时间：
2023-02-16
期刊：
影响因子：
6.1
通讯作者：
Nazarian, Saman
中科院分区：
文献类型：
--
作者：
Xu, Lingyu;Zahid, Sohail;Khoshknab, Mirmilad;Moss, Juwann;Berger, Ronald D.;Chrispin, Jonathan;Callans, David;Marchlinski, Francis E.;Zimmerman, Stefan L.;Han, Yuchi;Desjardins, Benoit;Trayanova, Natalia;Nazarian, Saman
关键词：
梗死后心肌含有穿过瘢痕或脂肪瘤性化生（LM）的存活通道。室性心动过速（VT）回路已被单独报告与穿越LM的通道和复极异质性相关。我们研究了通道激活恢复间期（ARI）和ARI离散度与周围组织类型的关系。该队列包括来自前瞻性心肌病心肌内脂肪沉积和室性心动过速（INFINITY）研究的33例梗死后患者。我们共同登记了晚期钆增强磁共振的瘢痕和走廊，以及计算机断层扫描的LM和心内电图位置。在窦性或心室起搏期间计算激动恢复间期，作为单极电描记图上QRS内最小导数至T波内最大导数的时间间期。区域ARI离散度定义为每个AHA节段ARI的标准差（ARISD）。脂肪瘤化生的ARI高于瘢痕[325（四分位距270-392）vs. 313（255-374），P < 0.001]。与非关键性通道相比，对室性心动过速折返至关重要的通道更有可能穿过或靠近LM，并显示出较长的ARI [355（319-397）vs. 302（279-333）ms，P < 0.001]。与瘢痕相比，ARISD与LM的相关性更密切（似然比χ2 50 vs. 12，每个AHA节段每增加1 cm 2，0.01*Log（ARISD）增加4.2单位vs. 0.9单位）。此外，LM和瘢痕在与ARISD的相关性中表现出相互作用（P < 0.001）。脂肪瘤性化生与通道的局部动作电位持续时间延长和ARI离散度密切相关，这可能促进VT回路折返的倾向。
Post-infarct myocardium contains viable corridors traversing scar or lipomatous metaplasia (LM). Ventricular tachycardia (VT) circuitry has been separately reported to associate with corridors that traverse LM and with repolarization heterogeneity. We examined the association of corridor activation recovery interval (ARI) and ARI dispersion with surrounding tissue type. The cohort included 33 post-infarct patients from the prospective Intra-Myocardial Fat Deposition and Ventricular Tachycardia in Cardiomyopathy (INFINITY) study. We co-registered scar and corridors from late gadolinium enhanced magnetic resonance, and LM from computed tomography with intracardiac electrogram locations. Activation recovery interval was calculated during sinus or ventricular pacing, as the time interval from the minimum derivative within the QRS to the maximum derivative within the T-wave on unipolar electrograms. Regional ARI dispersion was defined as the standard deviation (SD) of ARI per AHA segment (ARISD). Lipomatous metaplasia exhibited higher ARI than scar [325 (interquartile range 270–392) vs. 313 (255–374), P < 0.001]. Corridors critical to VT re-entry were more likely to traverse through or near LM and displayed prolonged ARI compared with non-critical corridors [355 (319–397) vs. 302 (279–333) ms, P < 0.001]. ARISD was more closely associated with LM than with scar (likelihood ratio χ2 50 vs. 12, and 4.2-unit vs. 0.9-unit increase in 0.01*Log(ARISD) per 1 cm2 increase per AHA segment). Additionally, LM and scar exhibited interaction (P < 0.001) in their association with ARISD. Lipomatous metaplasia is closely associated with prolonged local action potential duration of corridors and ARI dispersion, which may facilitate the propensity of VT circuit re-entry.
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影响因子：
7
作者：
Callans, David J.;Donahue, Kevin
通讯作者：
Donahue, Kevin
影响因子：
5.5
作者：
Sasaki, Takeshi;Calkins, Hugh;Zimmerman, Stefan L.
通讯作者：
Zimmerman, Stefan L.
影响因子：
20.1
作者：
PRYSTOWSKY, EN;JACKMAN, WM;ZIPES, DP
通讯作者：
ZIPES, DP
影响因子：
37.8
作者：
MILLAR, CK;KRALIOS, FA;LUX, RL
通讯作者：
LUX, RL
影响因子：
37.8
作者：
DEBAKKER, JMT;VANCAPELLE, FJL;HAUER, RNW
通讯作者：
HAUER, RNW