In a swine model of healed myocardial infarction, significantly slower conduction velocity was observed in LGE+ (0.33 vs 0.54 m/s; P<0.001) and wall thinning+ regions (0.38 vs 0.55 m/s; P<0.001).
Does late gadolinium enhancement and myocardial wall thinning correlate with slower local conduction velocity in a swine model of healed myocardial infarction?
Slower conduction velocity is associated with late gadolinium enhancement and myocardial wall thinning, suggesting CMR may serve as a noninvasive surrogate for identifying arrhythmogenic substrates.
Absolute Event Rate: 0.33% vs 0.54%
p-value: p=<0.001
BACKGROUND: Conduction velocity (CV) is an important property that contributes to the arrhythmogenicity of the tissue substrate. The aim of this study was to investigate the association between local CV versus late gadolinium enhancement (LGE) and myocardial wall thickness in a swine model of healed left ventricular infarction. METHODS: Six swine with healed myocardial infarction underwent cardiovascular magnetic resonance imaging and electroanatomic mapping. Two healthy controls (one treated with amiodarone and one unmedicated) underwent electroanatomic mapping with identical protocols to establish the baseline CV. CV was estimated using a triangulation technique. LGE+ regions were defined as signal intensity >2 SD than the mean of remote regions, wall thinning+ as those with wall thickness <2 SD than the mean of remote regions. LGE heterogeneity was defined as SD of LGE in the local neighborhood of 5 mm and wall thickness gradient as SD within 5 mm. Cardiovascular magnetic resonance and electroanatomic mapping data were registered, and hierarchical modeling was performed to estimate the mean difference of CV (LGE+/-, wall thinning+/-), or the change of the mean of CV per unit change (LGE heterogeneity, wall thickness gradient). RESULTS: Significantly slower CV was observed in LGE+ (0.33±0.25 versus 0.54±0.36 m/s; P<0.001) and wall thinning+ regions (0.38±0.28 versus 0.55±0.37 m/s; P<0.001). Areas with greater LGE heterogeneity ( P<0.001) and wall thickness gradient ( P<0.001) exhibited slower CV. CONCLUSIONS: Slower CV is observed in the presence of LGE, myocardial wall thinning, high LGE heterogeneity, and a high wall thickness gradient. Cardiovascular magnetic resonance may offer a valuable imaging surrogate for estimating CV, which may support noninvasive identification of the arrhythmogenic substrate.
Jang et al. (Mon,) conducted a other in Healed left ventricular infarction (n=8). Cardiovascular magnetic resonance imaging and electroanatomic mapping vs. Remote/healthy regions (LGE- or wall thinning-) was evaluated on Conduction velocity in LGE+ versus LGE- regions (p=<0.001). In a swine model of healed myocardial infarction, significantly slower conduction velocity was observed in LGE+ (0.33 vs 0.54 m/s; P<0.001) and wall thinning+ regions (0.38 vs 0.55 m/s; P<0.001).