September 27, 2021Scientific ReportsOpen Access

Transmural scar assessment using 3D-upsampled models from 2D LGE-CMR images revealed that patients with ventricular tachycardia recurrences had significantly lower scar areas compared to those without recurrences (64.0 vs 83.0 cm2, p=0.04).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Ischemic cardiomyopathy with spontaneous ventricular tachycardia (n=14). Intervention: 3D-upsampled models from 2D LGE-CMR images vs. Conventional 2D LGE-CMR assessment. Primary outcome: Scar area on 3D-upsampled models (transmurality < 0.2) in patients with vs without VT recurrences (p=0.04).

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Why the study?

LGE-CMR requires novel and time-efficient approaches to characterize the myocardial substrate associated with ventricular arrhythmia in patients with ischemic cardiomyopathy.

Does 3D-upsampled transmural scar assessment from 2D LGE-CMR images improve the characterization of myocardial substrate associated with VT features and recurrences compared to conventional 2D assessment in ischemic cardiomyopathy?

Population

Pigs and patients with established myocardial infarction

Comparison

3D-upsampled models from 2D LGE-CMR images vs 3D-acquired sequences and conventional 2D assessment

Design

Translational validation study

Key result

Transmural scar assessment using 3D-upsampled models from 2D LGE-CMR images revealed that patients with ventricular tachycardia recurrences had significantly lower scar areas compared to those without recurrences (64.0 vs 83.0 cm2, p=0.04).

Authors

SMSusana Merino‐Caviedes LGLilian K. Gutiérrez JAJosé Manuel Alfonso-Almazán

Discussion

Member takes

Overview

Questions scar burden as VT recurrence predictor; leaves open validation of 3D-upsampled LGE-CMR models.

Study Design

Type

Cohort (n=14)

Multicenter

Yes

Structured PICO

Population

14 patients (median age 69.3 years, 14.3% female) with ischemic cardiomyopathy and spontaneous ventricular tachycardia episodes, followed for 5 years after ablation.

Exposure

3D-upsampled models from 2D delayed gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) images for transmural scar assessment.

Comparator

Conventional 2D LGE-CMR assessment and 3D-acquired LGE-CMR sequences.

Outcome

Correlation of scar size/volume with the cycle length of spontaneous ventricular tachycardia episodes and long-term ventricular tachycardia recurrences after catheter ablation.surrogate

Main Result

Absolute Event Rate: 64% vs 83%

p-value: p=0.04

A novel 3D-upsampled methodology from standard 2D LGE-CMR images provides a time-efficient and superior alternative to conventional 2D assessment for characterizing arrhythmogenic scar substrate and predicting VT recurrences in ischemic cardiomyopathy.

Limitations

Time-to-imaging acquisition after gadolinium administration was not the same for 3D and 2D LGE-CMR acquisitions
Clinical implications of transmural scar assessment in spontaneous VT features were only studied in patients with established myocardial infarction
Statistical association of scar areas derived from transmurality analysis with VT recurrences might have been affected by individual specific substrate modification during the ablation procedure

Cite This Study

Merino‐Caviedes et al. (2021) conducted a cohort in Ischemic cardiomyopathy with spontaneous ventricular tachycardia (n=14). 3D-upsampled models from 2D LGE-CMR images vs. Conventional 2D LGE-CMR assessment was evaluated on Scar area on 3D-upsampled models (transmurality < 0.2) in patients with vs without VT recurrences (p=0.04). Transmural scar assessment using 3D-upsampled models from 2D LGE-CMR images revealed that patients with ventricular tachycardia recurrences had significantly lower scar areas compared to those without recurrences (64.0 vs 83.0 cm2, p=0.04).

synapsesocial.com/papers/6a70796ba2d7cf2e39c2ac38 https://doi.org/10.1038/s41598-021-97399-w

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September 27, 2021Scientific ReportsOpen Access

Transmural scar assessment using 3D-upsampled models from 2D LGE-CMR images revealed that patients with ventricular tachycardia recurrences had significantly lower scar areas compared to those without recurrences (64.0 vs 83.0 cm2, p=0.04).

View Full Paper

Ask AI

Bookmark

Why the study?

LGE-CMR requires novel and time-efficient approaches to characterize the myocardial substrate associated with ventricular arrhythmia in patients with ischemic cardiomyopathy.

Population

Pigs and patients with established myocardial infarction

Comparison

3D-upsampled models from 2D LGE-CMR images vs 3D-acquired sequences and conventional 2D assessment

Design

Translational validation study

Key result

Authors

SMSusana Merino‐Caviedes LGLilian K. Gutiérrez JAJosé Manuel Alfonso-Almazán

Discussion

Member takes

Overview

Questions scar burden as VT recurrence predictor; leaves open validation of 3D-upsampled LGE-CMR models.

Study Design

Type

Cohort (n=14)

Multicenter

Yes

Structured PICO

Population

14 patients (median age 69.3 years, 14.3% female) with ischemic cardiomyopathy and spontaneous ventricular tachycardia episodes, followed for 5 years after ablation.

Exposure

3D-upsampled models from 2D delayed gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) images for transmural scar assessment.

Comparator

Conventional 2D LGE-CMR assessment and 3D-acquired LGE-CMR sequences.

Outcome

Correlation of scar size/volume with the cycle length of spontaneous ventricular tachycardia episodes and long-term ventricular tachycardia recurrences after catheter ablation.surrogate

Main Result

Absolute Event Rate: 64% vs 83%

p-value: p=0.04

Limitations

Time-to-imaging acquisition after gadolinium administration was not the same for 3D and 2D LGE-CMR acquisitions
Clinical implications of transmural scar assessment in spontaneous VT features were only studied in patients with established myocardial infarction
Statistical association of scar areas derived from transmurality analysis with VT recurrences might have been affected by individual specific substrate modification during the ablation procedure

Cite This Study

synapsesocial.com/papers/6a70796ba2d7cf2e39c2ac38 https://doi.org/10.1038/s41598-021-97399-w

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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