期刊
EUROPACE
卷 21, 期 1, 页码 163-174出版社
OXFORD UNIV PRESS
DOI: 10.1093/europace/euy192
关键词
Magnetic resonance imaging; T1 mapping; Myocardial infarction; Voltage mapping; Myocardial substrate
资金
- Ministry of Economy, Industry and Competitiveness (MEIC)
- Pro CNIC Foundation
- CNIC [SEV-2015-0505]
- BSC (Barcelona, Spain) [SEV-2011-0067]
- Instituto de Salud Carlos III, Fondo Europeo de Desarrollo Regional [RD12/0042/0036, CB16/11/00458]
- Spanish Ministry of Economy and Competitiveness (MINECO) [SAF2016-80324-R, PI16/02110, DTS17/00136]
- European Commission [JTC2016/APCIN-ISCIII-2016, AC16/00021]
- Fundacion Interhospitalaria para la Investigacion Cardiovascular (FIC, Madrid, Spain)
- heart rhyhtm section of the Spanish Society of Cardiology
- National Heart Lung and Blood Institute, USA, National Institutes of Health [HL122352]
- CompBioMed project European Union's Horizon 2020 research and innovation program [H2020-EU.1.4.1.3, 675451]
- 'la Caixa' Fellowship Grant for Doctoral Studies, 'la Caixa' Banking Foundation, Barcelona, Spain
Aims We aimed to study the differences in biventricular scar characterization using bipolar voltage mapping compared with state-of-the-art in vivo delayed gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) imaging and ex vivo T1 mapping. Methods and results Ten pigs with established myocardial infarction (MI) underwent in vivo scar characterization using LGE-CMR imaging and high-density voltage mapping of both ventricles using a 3.5-mm tip catheter. Ex vivo post-contrast T1 mapping provided a high-resolution reference. Voltage maps were registered onto the left and right ventricular (LV and RV) endocardium, and epicardium of CMR-based geometries to compare voltage-derived scars with surface-projected 3D scars. Voltage-derived scar tissue of the LV endocardium and the epicardium resembled surface projections of 3D in vivo and ex vivo CMR-derived scars using 1-mm of surface projection distance. The thinner watt of the RV was especially sensitive to lower resolution in vivo LGE-CMR images, in which differences between normalized low bipolar voltage areas and CMR-derived scar areas did not decrease below a median of 8.84% [interquartile range (IQR) (3.58, 12.70%)]. Overall, voltage-derived scars and surface scar projections from in vivo LGE-CMR sequences showed larger normalized scar areas than high-resolution ex vivo images [12.87% (4.59, 27.15%), 18.51% (11.25, 24.61%), and 9.30% (184, 19.59%), respectively], despite having used optimized surface projection distances. Importantly, 43.02% (36.54, 48.72%) of voltage-derived scar areas from the LV endocardium were classified as non-enhanced healthy myocardium using ex vivo CMR imaging. Conclusion In vivo LGE-CMR sequences and high-density voltage mapping using a conventional linear catheter fail to provide accu- rate characterization of post-MI scar, limiting the specificity of voltage-based strategies and imaging-guided procedures.
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