PMID- 30354675
OWN - NLM
STAT- MEDLINE
DCOM- 20190902
LR  - 20190902
IS  - 1942-0080 (Electronic)
IS  - 1941-9651 (Print)
IS  - 1941-9651 (Linking)
VI  - 11
IP  - 9
DP  - 2018 Sep
TI  - Regional Strain by Cardiac Magnetic Resonance Imaging Improves Detection of Right 
      Ventricular Scar Compared With Late Gadolinium Enhancement on a Multimodality 
      Scar Evaluation in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy.
PG  - e007546
LID - 10.1161/CIRCIMAGING.118.007546 [doi]
AB  - BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy is an inherited 
      cardiomyopathy characterized by fibrofatty replacement of right ventricular 
      myocardium resulting in reentrant ventricular tachycardia (VT). Cardiac magnetic 
      resonance imaging (CMR) can noninvasively measure regional abnormalities using 
      tissue-tracking strain as well as late gadolinium enhancement (LGE). In this 
      study, we examine arrhythmogenic substrate using regional CMR strain, LGE, and 
      electroanatomic mapping (EAM) in arrhythmogenic right ventricular cardiomyopathy 
      patients presenting for VT ablation. METHODS AND RESULTS: Twenty-one patients 
      underwent right ventricular endocardial EAM, whereas 17 underwent epicardial EAM, 
      to detect dense scar (<0.5 mV) as well as CMR study within 12 months. 
      Quantitative regional strain analysis was performed in all 21 patients, although 
      the presence of LGE was visually examined in 17 patients. Strain was lower in 
      segments with dense scar on endocardial and epicardial EAM (-9.7+/-4.1 versus 
      -7.3+/-4.0, and -9.8+/-2.8 versus -7.6+/-3.8; P<0.05), in segments with LGE scar 
      (-9.9+/-4.4 versus -6.0+/-3.6; P=0.001), and at VT culprit sites (-7.4+/-3.7 versus 
      -10.1+/-4.1; P<0.001), compared with the rest of right ventricular. On 
      patient-clustered analysis, a unit increase in strain was associated with 21% and 
      18% decreased odds of scar on endocardial and epicardial EAM, respectively, 17% 
      decreased odds of colocalizing VT culprit site, and 43% decreased odds of scar on 
      LGE-CMR ( P<0.05 for all). LGE and EAM demonstrated poor agreement with kappa=0.18 
      (endocardial, n=17) and kappa=0.06 (epicardial, n=13). Only 8 (15%) VT termination 
      sites exhibited LGE. CONCLUSIONS: Regional myocardial strain on cine CMR improves 
      detection of arrhythmogenic VT substrate compared with LGE. This may enhance 
      diagnostic accuracy of CMR in arrhythmogenic right ventricular cardiomyopathy 
      without the need for invasive procedures and facilitate the planning of VT 
      ablation procedures.
FAU - Zghaib, Tarek
AU  - Zghaib T
AD  - Precision Medicine Center of Excellence for ARVC and Complex Ventricular 
      Arrhythmias, Johns Hopkins University School of Medicine, Baltimore, MD (T.Z., 
      F.R.A., J.C., A.K., S.M., R.B., H.C., H.T.).
FAU - Ghasabeh, Mounes Aliyari
AU  - Ghasabeh MA
AD  - Department of Radiology and Radiological Sciences, Johns Hopkins University 
      School of Medicine, Baltimore, MD (M.A.G., I.K., S.Z.).
FAU - Assis, Fabrizio R
AU  - Assis FR
AD  - Precision Medicine Center of Excellence for ARVC and Complex Ventricular 
      Arrhythmias, Johns Hopkins University School of Medicine, Baltimore, MD (T.Z., 
      F.R.A., J.C., A.K., S.M., R.B., H.C., H.T.).
FAU - Chrispin, Jonathan
AU  - Chrispin J
AD  - Precision Medicine Center of Excellence for ARVC and Complex Ventricular 
      Arrhythmias, Johns Hopkins University School of Medicine, Baltimore, MD (T.Z., 
      F.R.A., J.C., A.K., S.M., R.B., H.C., H.T.).
FAU - Keramati, Ali
AU  - Keramati A
AD  - Precision Medicine Center of Excellence for ARVC and Complex Ventricular 
      Arrhythmias, Johns Hopkins University School of Medicine, Baltimore, MD (T.Z., 
      F.R.A., J.C., A.K., S.M., R.B., H.C., H.T.).
FAU - Misra, Satish
AU  - Misra S
AD  - Precision Medicine Center of Excellence for ARVC and Complex Ventricular 
      Arrhythmias, Johns Hopkins University School of Medicine, Baltimore, MD (T.Z., 
      F.R.A., J.C., A.K., S.M., R.B., H.C., H.T.).
FAU - Berger, Ronald
AU  - Berger R
AD  - Precision Medicine Center of Excellence for ARVC and Complex Ventricular 
      Arrhythmias, Johns Hopkins University School of Medicine, Baltimore, MD (T.Z., 
      F.R.A., J.C., A.K., S.M., R.B., H.C., H.T.).
FAU - Calkins, Hugh
AU  - Calkins H
AD  - Precision Medicine Center of Excellence for ARVC and Complex Ventricular 
      Arrhythmias, Johns Hopkins University School of Medicine, Baltimore, MD (T.Z., 
      F.R.A., J.C., A.K., S.M., R.B., H.C., H.T.).
FAU - Kamel, Ihab
AU  - Kamel I
AD  - Department of Radiology and Radiological Sciences, Johns Hopkins University 
      School of Medicine, Baltimore, MD (M.A.G., I.K., S.Z.).
FAU - Nazarian, Saman
AU  - Nazarian S
AD  - Department of Radiology and Radiological Sciences, Johns Hopkins University 
      School of Medicine, Baltimore, MD (M.A.G., I.K., S.Z.).
FAU - Zimmerman, Stefan
AU  - Zimmerman S
AD  - Division of Cardiology, University of Pennsylvania Perelman School of Medicine, 
      Philadelphia (S.N.).
FAU - Tandri, Harikrishna
AU  - Tandri H
AD  - Precision Medicine Center of Excellence for ARVC and Complex Ventricular 
      Arrhythmias, Johns Hopkins University School of Medicine, Baltimore, MD (T.Z., 
      F.R.A., J.C., A.K., S.M., R.B., H.C., H.T.).
LA  - eng
GR  - K23 HL089333/HL/NHLBI NIH HHS/United States
GR  - R01 HL116280/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Circ Cardiovasc Imaging
JT  - Circulation. Cardiovascular imaging
JID - 101479935
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
CIN - Circ Cardiovasc Imaging. 2018 Sep;11(9):e008271. PMID: 30354682
MH  - Adult
MH  - Arrhythmogenic Right Ventricular Dysplasia/complications/*diagnostic 
      imaging/pathology/physiopathology
MH  - Catheter Ablation
MH  - Contrast Media/*administration & dosage
MH  - Electrophysiologic Techniques, Cardiac
MH  - Female
MH  - Gadolinium DTPA/*administration & dosage
MH  - Heart Ventricles/*diagnostic imaging/pathology/physiopathology/surgery
MH  - Humans
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - *Myocardial Contraction
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Tachycardia, Ventricular/diagnosis/physiopathology/surgery
MH  - Treatment Outcome
MH  - *Ventricular Function, Right
MH  - Young Adult
PMC - PMC6207200
MID - NIHMS1504444
OTO - NOTNLM
OT  - cardiomyopathy
OT  - endocardium
OT  - gadolinium
OT  - magnetic resonance imaging
OT  - myocardium
EDAT- 2018/10/26 06:00
MHDA- 2019/09/03 06:00
PMCR- 2019/09/01
CRDT- 2018/10/26 06:00
PHST- 2018/10/26 06:00 [entrez]
PHST- 2018/10/26 06:00 [pubmed]
PHST- 2019/09/03 06:00 [medline]
PHST- 2019/09/01 00:00 [pmc-release]
AID - 10.1161/CIRCIMAGING.118.007546 [doi]
PST - ppublish
SO  - Circ Cardiovasc Imaging. 2018 Sep;11(9):e007546. doi: 
      10.1161/CIRCIMAGING.118.007546.