Author + information
- Adaya Weissler-Snir,
- Waseem Hindieh,
- Danna Spears,
- Arnon Adler,
- Dana Fourey,
- Harry Rakowski and
- Raymond H. Chan
Background: Non-sustained ventricular tachycardia (NSVT) has been shown to be independently associated with sudden death in hypertrophic cardiomyopathy (HCM). Previous studies have found late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) to be independently associated with the presence of NSVT. We sought to examine the relationship between LGE extent and NSVT characteristics in HCM.
Methods: Between 4/2014-5/2016, 79 patients underwent 14-day Holter monitoring at Toronto General Hospital. Of these, 73 patients had a CMR study. Number of episodes of NSVT, duration and rate of the longest and fastest episodes on each day were documented. LGE was defined quantitatively by a myocardial post-contrast signal intensity 6SD above that within a reference region of remote myocardium within the same slice.
Results: Patients with more extensive LGE had longer (p=0.0028) and more frequent (p=0.02) episodes of NSVT. In univariate analyses, maximal length of NSVT was associated with LGE extent (rs=0.5, p<0.001), left ventricular (LV) ejection fraction (rs=-0.44, p=0.0001) and LV mass (rs=0.37, p=0.001); frequency of NSVT was associated with LGE extent (rs=0.4, p=0.0028), LV ejection fraction (rs=-0.38, p=0.0008), LV mass (rs=0.32, p=0.0054) and LV maximal wall thickness (rs=0.28, p=0016). In multivariable analyses, LGE extent remained the sole variable independently associated with frequency (p=0.012) and maximal length of episodes of NSVT (p=0.0035). There was no association between LGE extent and maximal rate of NSVT.
Conclusions: LGE extent is independently associated with greater burden and more prolonged episodes of NSVT in HCM. These findings support the association between myocardial fibrosis as assessed by CMR and ventricular tachyarrhythmias in HCM.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: MR Scar and Perfusion
Abstract Category: 29. Non Invasive Imaging: MR
Presentation Number: 1244-204
- 2017 American College of Cardiology Foundation