Identification of the potentially arrhythmogenic substrate in the acute phase of ST-segment elevation myocardial infarction
Identification of the potentially arrhythmogenic substrate in the acute phase of ST-segment elevation myocardial infarction
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DOI：
10.1016/j.hrthm.2017.01.019
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发表时间：
2017-04-01
期刊：
影响因子：
5.5
通讯作者：
Berruezo, Antonio
中科院分区：
文献类型：
--
作者：
Penela, Diego;Acosta, Juan;Berruezo, Antonio
背景：预测ST段抬高性心肌梗死(STEMI)后最初几个月的心脏性猝死风险仍然具有挑战性。目的：本研究的目的是探讨晚期Gd增强心脏磁共振(LGE-CMR)对STEMI后潜在致心律失常底物及其时间演变的识别能力。在3T条件下，分别于第7天和180天获得高分辨率三维LGE-CMR图像。采用像素信号强度算法从心内膜至心外膜5层分割左室壁并对其进行表征。获得每一层的三维彩色编码贝壳图，描绘瘢痕核心和边界区域(BZ)的分布。结果：180d时，左心室射血分数明显改善(从46.7%+/-10%提高到51.5%+/-10%；P
BACKGROUND: Predicting sudden cardiac death risk in the first months after ST-segment elevation myocardial infarction (STEMI) remains challenging.OBJECTIVE: The purpose of this study was to investigate the ability of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) to identify the potentially arrhythmogenic substrate and its temporal evolution after STEMI.METHODS: One hundred consecutive patients with a first STEMI were included. Three-dimensional high-resolution LGE-CMR was obtained at 3 T on days 7 and 180. Left ventricular wall was segmented and characterized by pixel signal intensity algorithm in 5 layers from endocardium to epicardium. A 3-dimensional color-coded shell map was obtained for each layer, depicting scar core and border zone (BZ) distribution. Presence and characteristics of BZ channels were registered for each layer.RESULTS: At 180 days, left ventricular ejection fraction had improved significantly (from 46.7% +/- 10% to 51.5% +/- 10%; P