Diego Penela 1 , Mikel Martínez 2 , Juan Fernández-Armenta 3 , Luis Aguinaga 4 , Luis Tercedor 5 , Augusto Ordóñez 6 , Juan Acosta 7 , Julio Martí-Almor 8 , Felipe Bisbal 9,10 , Luca Rossi 1 , Roger Borràs 2 , Markus Linhart 2 , David Soto-Iglesias 2 , Beatriz Jáuregui 2 , José T Ortiz-Pérez 2 , Rosario J Perea 2 , Xavier Bosch 2 , Lluis Mont 2,10 , Antonio Berruezo 11 Show Affiliations »
Abstract
OBJECTIVE: This study aims to evaluate the influence of myocardial scar after premature ventricular complexes (PVC) ablation in patients with left ventricular (LV) dysfunction. METHODS: 70 consecutive patients (58±11 years, 58 (83%) men, 23% (18-32) mean PVC burden) with LV dysfunction and frequent PVCs submitted for ablation were included. A late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) was performed prior to the ablation and a quantitative and qualitative analysis of the scar was done. RESULTS: Left ventricular ejection fraction progressively improved from 34.3%±9% at baseline to 44.4%±12% at 12 months (p<0.01) and 48 (69%) patients were echocardiographic responders. New York Heart Association class improved from 1.96±0.9 points at baseline to 1.36±0.6 at 12 months (p<0.001). Brain natriuretic peptide decreased from 120 (60-284) to 46 (23-81) pg/mL (p=0.04). Twenty-nine (41%) patients showed scar in the preprocedural LGE-CMR with a mean scar mass of 10.4 (5-20) g. Mean scar mass was significantly smaller in responders than in non-responders (0 (0-4.7) g vs 2 (0-14) g, respectively, p=0.017). PVC burden reduction (OR 1.09 (1.01-1.16), p=0.02) and scar mass (OR 0.9 (0.81-0.99), p=0.04) were independent predictors of response, but the former showed a higher accuracy. CONCLUSIONS: Presence of myocardial scar modulates, but does not preclude, the probability of response to PVC ablation in patients with LV dysfunction. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
OBJECTIVE: This study aims to evaluate the influence of myocardial scar after premature ventricular complexes (PVC) ablation in patients with left ventricular (LV) dysfunction . METHODS: 70 consecutive patients (58±11 years, 58 (83%) men , 23% (18-32) mean PVC burden) with LV dysfunction and frequent PVCs submitted for ablation were included. A late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) was performed prior to the ablation and a quantitative and qualitative analysis of the scar was done. RESULTS: Left ventricular ejection fraction progressively improved from 34.3%±9% at baseline to 44.4%±12% at 12 months (p<0.01) and 48 (69%) patients were echocardiographic responders. New York Heart Association class improved from 1.96±0.9 points at baseline to 1.36±0.6 at 12 months (p<0.001). Brain natriuretic peptide decreased from 120 (60-284) to 46 (23-81) pg/mL (p=0.04). Twenty-nine (41%) patients showed scar in the preprocedural LGE-CMR with a mean scar mass of 10.4 (5-20) g. Mean scar mass was significantly smaller in responders than in non-responders (0 (0-4.7) g vs 2 (0-14) g, respectively, p=0.017). PVC burden reduction (OR 1.09 (1.01-1.16), p=0.02) and scar mass (OR 0.9 (0.81-0.99), p=0.04) were independent predictors of response, but the former showed a higher accuracy. CONCLUSIONS: Presence of myocardial scar modulates, but does not preclude, the probability of response to PVC ablation in patients with LV dysfunction . © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Chemical
Disease
Species
Keywords:
ablation; cardiac magnetic resonance; left ventricular dysfunction; myocardial scar; premature ventricular complex
Year: 2018
PMID： 30242139 DOI： 10.1136/heartjnl-2018-313452
Source DB: PubMed Journal: Heart ISSN： 1355-6037 Impact factor: 5.994