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The relationship between left ventricular scar and ventricular repolarization in patients with coronary artery disease: insights from late gadolinium enhancement magnetic resonance imaging.
MedLine Citation:
PMID:  23143860     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: The markers of ventricular repolarization corrected QT interval (QTc), QT dispersion (QTD) and Tpeak-to-Tend interval (Tpeak-end) have shown an association with sudden cardiac death (SCD) in the general population. However, their mechanistic relationship with SCD is unclear. The study aim was to evaluate the relationship between QTc, QTD, and Tpeak-end, and the extent and distribution of left ventricular (LV) scar in patients with coronary artery disease at high SCD risk.METHODS AND RESULTS: We included 64 consecutive implantable cardioverter defibrillator (ICD) recipients (66 ± 11 years, 80% male, median left ventricular ejection fraction 30%) who had undergone late gadolinium enhancement cardiac magnetic resonance (CMR) imaging prior to device implantation over 4 years. Scar was quantified using the CMR images and characterized in terms of percent LV scar and number of LV segments with subendocardial/transmural scar. Repolarization parameters were measured on an electrocardiogram performed prior to ICD implantation. After adjustment for potential confounders there was a strong association between the number of limited subendocardial (1-25% transmurality) scar segments and QTc (P = 0.003), QTD (P = 0.002), and Tpeak-end (P = 0.008). However, there was no association between the repolarization parameters and percent LV scar or the amount of transmural scar. During a mean follow-up of 19 ± 10 months 19 (30%) patients received appropriate ICD therapy, but none of the repolarization parameters were associated with its occurrence.CONCLUSION: In this pilot study there was a strong association between limited subendocardial LV scar and prolonged QTc, QTD, and Tpeak-end. However, there was no association between any of these repolarization markers and the delivery of appropriate ICD therapy.
Authors:
Paul A Scott; James A Rosengarten; Anwar Shahed; Arthur M Yue; David C Murday; Paul R Roberts; Charles R Peebles; Stephen P Harden; Nick P Curzen; John M Morgan
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-9
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  -     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Wessex Cardiothoracic Unit, Southampton University Hospitals NHS Trust, Tremona Road, Southampton SO16 6YD, UK.
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