Conductive channels identified with contrast-enhanced MR imaging predict ventricular tachycardia in systolic heart failure

Lian Yu Lin, Mao Yuan M. Su, Jien Jiun Chen, Ling Ping Lai, Juey Jen Hwang, Chuen Den Tseng, Yih Sharng Chen, Hsi Yu Yu, Wen Yih I. Tseng, Jiunn Lee Lin

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives This study evaluated whether the conductive channel (CC) identified by late gadolinium enhanced-cardiac magnetic resonance (LGE-CMR) is associated with ventricular tachycardia (VT) in patients with systolic heart failure (HF). Background One recent study demonstrated that the CC formed by heterogeneous tissue within the core scar could be detected by LGE-CMR and that the CC is responsible for clinical VT. We hypothesized that the CC could help identify HF patients at risk for VT. Methods A total of 63 patients from a CMR database with left ventricular ejection fraction (LVEF) below 50% and with hyperenhancement on LGE-CMR were included. The cine and LGE images were analyzed to derive the LV function and scar characteristics, and to identify the CC. The outcomes, including VT, ventricular fibrillation (VF), and total mortality, were obtained by reviewing medical records. Results After a median 1,379 (interquartile range: 271 to 1,896) days of follow-up, 8 patients had VT/VF attacks and 14 patients died. Among the CMR-measured parameters, only the probability of identifying the CC by LGE-CMR was higher in patients with VT/VF than those without VT/VF (75.0% vs. 16.4%, p < 0.001). The probability of identifying the CC was also higher in the total mortality group than the survival group (50.0% vs. 16.3%, p = 0.004). The other LGE-CMR variables were not significantly different between the 2 groups. A univariate Cox regression model showed that CC identification was positively associated with VT/VF attacks (hazard ratio [HR]: 27.032, 95% confidence interval [CI]: 3.291 to 222.054, p = 0.002) and excess total mortality (HR: 4.766, 95% CI: 1.643 to 13.824, p = 0.004). The LVEF was inversely associated with VT/VF attacks (HR: 0.119, 95% CI: 0.015 to 0.977, p = 0.048) and excess total mortality (HR: 0.491, 95% CI: 0.261 to 0.925, p = 0.028) during follow-up. Conclusions We demonstrated that CC identification using LGE-CMR can help identify HF patients at risk for VT/VF.

Original languageEnglish
Pages (from-to)1152-1159
Number of pages8
JournalJACC: Cardiovascular Imaging
Volume6
Issue number11
DOIs
Publication statusPublished - Nov 1 2013
Externally publishedYes

Fingerprint

Systolic Heart Failure
Ventricular Tachycardia
Ventricular Fibrillation
Gadolinium
Magnetic Resonance Spectroscopy
Confidence Intervals
Mortality
Stroke Volume
Cicatrix
Heart Failure
Proportional Hazards Models
Medical Records
Databases

Keywords

  • conductive channel
  • congestive heart failure
  • magnetic resonance image

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Conductive channels identified with contrast-enhanced MR imaging predict ventricular tachycardia in systolic heart failure. / Lin, Lian Yu; Su, Mao Yuan M.; Chen, Jien Jiun; Lai, Ling Ping; Hwang, Juey Jen; Tseng, Chuen Den; Chen, Yih Sharng; Yu, Hsi Yu; Tseng, Wen Yih I.; Lin, Jiunn Lee.

In: JACC: Cardiovascular Imaging, Vol. 6, No. 11, 01.11.2013, p. 1152-1159.

Research output: Contribution to journalArticle

Lin, Lian Yu ; Su, Mao Yuan M. ; Chen, Jien Jiun ; Lai, Ling Ping ; Hwang, Juey Jen ; Tseng, Chuen Den ; Chen, Yih Sharng ; Yu, Hsi Yu ; Tseng, Wen Yih I. ; Lin, Jiunn Lee. / Conductive channels identified with contrast-enhanced MR imaging predict ventricular tachycardia in systolic heart failure. In: JACC: Cardiovascular Imaging. 2013 ; Vol. 6, No. 11. pp. 1152-1159.
@article{a33774afed694edbb0762bdf5e12295f,
title = "Conductive channels identified with contrast-enhanced MR imaging predict ventricular tachycardia in systolic heart failure",
abstract = "Objectives This study evaluated whether the conductive channel (CC) identified by late gadolinium enhanced-cardiac magnetic resonance (LGE-CMR) is associated with ventricular tachycardia (VT) in patients with systolic heart failure (HF). Background One recent study demonstrated that the CC formed by heterogeneous tissue within the core scar could be detected by LGE-CMR and that the CC is responsible for clinical VT. We hypothesized that the CC could help identify HF patients at risk for VT. Methods A total of 63 patients from a CMR database with left ventricular ejection fraction (LVEF) below 50{\%} and with hyperenhancement on LGE-CMR were included. The cine and LGE images were analyzed to derive the LV function and scar characteristics, and to identify the CC. The outcomes, including VT, ventricular fibrillation (VF), and total mortality, were obtained by reviewing medical records. Results After a median 1,379 (interquartile range: 271 to 1,896) days of follow-up, 8 patients had VT/VF attacks and 14 patients died. Among the CMR-measured parameters, only the probability of identifying the CC by LGE-CMR was higher in patients with VT/VF than those without VT/VF (75.0{\%} vs. 16.4{\%}, p < 0.001). The probability of identifying the CC was also higher in the total mortality group than the survival group (50.0{\%} vs. 16.3{\%}, p = 0.004). The other LGE-CMR variables were not significantly different between the 2 groups. A univariate Cox regression model showed that CC identification was positively associated with VT/VF attacks (hazard ratio [HR]: 27.032, 95{\%} confidence interval [CI]: 3.291 to 222.054, p = 0.002) and excess total mortality (HR: 4.766, 95{\%} CI: 1.643 to 13.824, p = 0.004). The LVEF was inversely associated with VT/VF attacks (HR: 0.119, 95{\%} CI: 0.015 to 0.977, p = 0.048) and excess total mortality (HR: 0.491, 95{\%} CI: 0.261 to 0.925, p = 0.028) during follow-up. Conclusions We demonstrated that CC identification using LGE-CMR can help identify HF patients at risk for VT/VF.",
keywords = "conductive channel, congestive heart failure, magnetic resonance image, conductive channel, congestive heart failure, magnetic resonance image",
author = "Lin, {Lian Yu} and Su, {Mao Yuan M.} and Chen, {Jien Jiun} and Lai, {Ling Ping} and Hwang, {Juey Jen} and Tseng, {Chuen Den} and Chen, {Yih Sharng} and Yu, {Hsi Yu} and Tseng, {Wen Yih I.} and Lin, {Jiunn Lee}",
year = "2013",
month = "11",
day = "1",
doi = "10.1016/j.jcmg.2013.05.017",
language = "English",
volume = "6",
pages = "1152--1159",
journal = "JACC: Cardiovascular Imaging",
issn = "1936-878X",
publisher = "Elsevier Inc.",
number = "11",

}

TY - JOUR

T1 - Conductive channels identified with contrast-enhanced MR imaging predict ventricular tachycardia in systolic heart failure

AU - Lin, Lian Yu

AU - Su, Mao Yuan M.

AU - Chen, Jien Jiun

AU - Lai, Ling Ping

AU - Hwang, Juey Jen

AU - Tseng, Chuen Den

AU - Chen, Yih Sharng

AU - Yu, Hsi Yu

AU - Tseng, Wen Yih I.

AU - Lin, Jiunn Lee

PY - 2013/11/1

Y1 - 2013/11/1

N2 - Objectives This study evaluated whether the conductive channel (CC) identified by late gadolinium enhanced-cardiac magnetic resonance (LGE-CMR) is associated with ventricular tachycardia (VT) in patients with systolic heart failure (HF). Background One recent study demonstrated that the CC formed by heterogeneous tissue within the core scar could be detected by LGE-CMR and that the CC is responsible for clinical VT. We hypothesized that the CC could help identify HF patients at risk for VT. Methods A total of 63 patients from a CMR database with left ventricular ejection fraction (LVEF) below 50% and with hyperenhancement on LGE-CMR were included. The cine and LGE images were analyzed to derive the LV function and scar characteristics, and to identify the CC. The outcomes, including VT, ventricular fibrillation (VF), and total mortality, were obtained by reviewing medical records. Results After a median 1,379 (interquartile range: 271 to 1,896) days of follow-up, 8 patients had VT/VF attacks and 14 patients died. Among the CMR-measured parameters, only the probability of identifying the CC by LGE-CMR was higher in patients with VT/VF than those without VT/VF (75.0% vs. 16.4%, p < 0.001). The probability of identifying the CC was also higher in the total mortality group than the survival group (50.0% vs. 16.3%, p = 0.004). The other LGE-CMR variables were not significantly different between the 2 groups. A univariate Cox regression model showed that CC identification was positively associated with VT/VF attacks (hazard ratio [HR]: 27.032, 95% confidence interval [CI]: 3.291 to 222.054, p = 0.002) and excess total mortality (HR: 4.766, 95% CI: 1.643 to 13.824, p = 0.004). The LVEF was inversely associated with VT/VF attacks (HR: 0.119, 95% CI: 0.015 to 0.977, p = 0.048) and excess total mortality (HR: 0.491, 95% CI: 0.261 to 0.925, p = 0.028) during follow-up. Conclusions We demonstrated that CC identification using LGE-CMR can help identify HF patients at risk for VT/VF.

AB - Objectives This study evaluated whether the conductive channel (CC) identified by late gadolinium enhanced-cardiac magnetic resonance (LGE-CMR) is associated with ventricular tachycardia (VT) in patients with systolic heart failure (HF). Background One recent study demonstrated that the CC formed by heterogeneous tissue within the core scar could be detected by LGE-CMR and that the CC is responsible for clinical VT. We hypothesized that the CC could help identify HF patients at risk for VT. Methods A total of 63 patients from a CMR database with left ventricular ejection fraction (LVEF) below 50% and with hyperenhancement on LGE-CMR were included. The cine and LGE images were analyzed to derive the LV function and scar characteristics, and to identify the CC. The outcomes, including VT, ventricular fibrillation (VF), and total mortality, were obtained by reviewing medical records. Results After a median 1,379 (interquartile range: 271 to 1,896) days of follow-up, 8 patients had VT/VF attacks and 14 patients died. Among the CMR-measured parameters, only the probability of identifying the CC by LGE-CMR was higher in patients with VT/VF than those without VT/VF (75.0% vs. 16.4%, p < 0.001). The probability of identifying the CC was also higher in the total mortality group than the survival group (50.0% vs. 16.3%, p = 0.004). The other LGE-CMR variables were not significantly different between the 2 groups. A univariate Cox regression model showed that CC identification was positively associated with VT/VF attacks (hazard ratio [HR]: 27.032, 95% confidence interval [CI]: 3.291 to 222.054, p = 0.002) and excess total mortality (HR: 4.766, 95% CI: 1.643 to 13.824, p = 0.004). The LVEF was inversely associated with VT/VF attacks (HR: 0.119, 95% CI: 0.015 to 0.977, p = 0.048) and excess total mortality (HR: 0.491, 95% CI: 0.261 to 0.925, p = 0.028) during follow-up. Conclusions We demonstrated that CC identification using LGE-CMR can help identify HF patients at risk for VT/VF.

KW - conductive channel

KW - congestive heart failure

KW - magnetic resonance image

KW - conductive channel

KW - congestive heart failure

KW - magnetic resonance image

UR - http://www.scopus.com/inward/record.url?scp=84888065137&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84888065137&partnerID=8YFLogxK

U2 - 10.1016/j.jcmg.2013.05.017

DO - 10.1016/j.jcmg.2013.05.017

M3 - Article

C2 - 24229767

AN - SCOPUS:84888065137

VL - 6

SP - 1152

EP - 1159

JO - JACC: Cardiovascular Imaging

JF - JACC: Cardiovascular Imaging

SN - 1936-878X

IS - 11

ER -