Cardiovascular magnetic resonance determinants of ventricular arrhythmic events after myocardial infarction

• Published in: Europace (London, England) England), 2022-07, Vol.24 (6), p.938-947
• Main Authors: Jáuregui, Beatriz, Soto-Iglesias, David, Penela, Diego, Acosta, Juan, Fernández-Armenta, Juan, Linhart, Markus, Ordóñez, Augusto, San Antonio, Rodolfo, Terés, Cheryl, Chauca, Alfredo, Carreño, José M, Scherer, Claudia, Falasconi, Giulio, Prat-González, Susana, Perea, Rosario J, Mont, Lluís, Bosch, Xavier, Ortiz-Pérez, José T, Berruezo, Antonio
• Format: Article
• Language: English
• ISSN: 1099-5129; 1532-2092
• DOI: 10.1093/europace/euab275

AIMSTo non-invasively characterize, by means of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR), scar differences, and potential variables associated with ventricular tachycardia (VT) occurrence in chronic post-myocardial infarction (MI) patients. METHODS AND RESULTSA case-control study was designed through retrospective LGE-CMR data analysis of chronic post-MI patients (i) consecutively referred for VT substrate ablation after a first VT episode (n = 66) and (ii) from a control group (n = 84) with no arrhythmia evidence. The myocardium was characterized differentiating core, border zone (BZ), and BZ channels (BZCs) using the ADAS 3D post-processing imaging platform. Clinical and scar characteristics, including a novel parameter, the BZC mass, were compared between both groups. One hundred and fifty post-MI patients were included. Four multivariable Cox proportional hazards regression models were created for total scar mass, BZ mass, core mass, and BZC mass, adjusting them by age, sex, and left ventricular ejection fraction (LVEF). A cut-off of 5.15 g of BZC mass identified the cases with 92.4% sensitivity and 86.9% specificity [area under the ROC curve (AUC) 0.93 (0.89-0.97); P