BACKGROUND: Patients with cardiac sarcoidosis (CS) are at increased risk of life-threatening ventricular arrhythmias (VA). Current approaches to risk stratification have limited predictive value. OBJECTIVES: To assess the utility of spatial dispersion analysis of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR), as a quantitative measure of myocardial tissue heterogeneity, in risk stratifying patients with CS for VA and death. METHODS: Sixty two patients with CS underwent LGE-CMR. LGE images were segmented and dispersion maps of the left and right ventricles were generated as follows. Based on signal intensity (SI), each pixel was categorized as abnormal (SI ≥3SD above the mean), intermediate (SI 1-3 SD above the mean) or normal (SI <1SD above the mean); and each pixel was then assigned a value of 0 to 8 based on the number of adjacent pixels of a different category. Average dispersion score was calculated for each patient. The primary endpoint was VA during follow up. The composite of VA or death was assessed as a secondary endpoint. RESULTS: During 4.7 ± 3.5 years of follow up, six patients had VA, and five without documented VA died. Average dispersion score was significantly higher in patients with VA versus those without (0.87 ± 0.08 vs. 0.71 ± 0.16; p = .002) and in patients with events versus those without (0.83 ± 0.08 vs. 0.70 ± 0.16; p = .003). Patients at higher tertiles of dispersion score had a higher incidence of VA (p = .03) and the composite of VA or death (p = .01). CONCLUSIONS: Increased substrate heterogeneity, quantified by spatial dispersion analysis of LGE-CMR, may be helpful in risk-stratifying patients with CS for adverse events, including life-threatening arrhythmias.
BACKGROUND: Patients with cardiac sarcoidosis (CS) are at increased risk of life-threatening ventricular arrhythmias (VA). Current approaches to risk stratification have limited predictive value. OBJECTIVES: To assess the utility of spatial dispersion analysis of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR), as a quantitative measure of myocardial tissue heterogeneity, in risk stratifying patients with CS for VA and death. METHODS: Sixty two patients with CS underwent LGE-CMR. LGE images were segmented and dispersion maps of the left and right ventricles were generated as follows. Based on signal intensity (SI), each pixel was categorized as abnormal (SI ≥3SD above the mean), intermediate (SI 1-3 SD above the mean) or normal (SI <1SD above the mean); and each pixel was then assigned a value of 0 to 8 based on the number of adjacent pixels of a different category. Average dispersion score was calculated for each patient. The primary endpoint was VA during follow up. The composite of VA or death was assessed as a secondary endpoint. RESULTS: During 4.7 ± 3.5 years of follow up, six patients had VA, and five without documented VA died. Average dispersion score was significantly higher in patients with VA versus those without (0.87 ± 0.08 vs. 0.71 ± 0.16; p = .002) and in patients with events versus those without (0.83 ± 0.08 vs. 0.70 ± 0.16; p = .003). Patients at higher tertiles of dispersion score had a higher incidence of VA (p = .03) and the composite of VA or death (p = .01). CONCLUSIONS: Increased substrate heterogeneity, quantified by spatial dispersion analysis of LGE-CMR, may be helpful in risk-stratifying patients with CS for adverse events, including life-threatening arrhythmias.
Authors: Katherine C Wu; Gary Gerstenblith; Eliseo Guallar; Joseph E Marine; Darshan Dalal; Alan Cheng; Eduardo Marbán; João A C Lima; Gordon F Tomaselli; Robert G Weiss Journal: Circ Cardiovasc Imaging Date: 2012-01-20 Impact factor: 7.792
Authors: Thomas Crawford; Gisela Mueller; Sinan Sarsam; Hutsaya Prasitdumrong; Naiyanet Chaiyen; Xiaokui Gu; Joseph Schuller; Jordana Kron; Khaled A Nour; Alan Cheng; Sang Yong Ji; Shawn Feinstein; Sanjaya Gupta; Karl Ilg; Mohamad Sinno; Saddam Abu-Hashish; Mouaz Al-Mallah; William H Sauer; Kenneth Ellenbogen; Fred Morady; Frank Bogun Journal: Circ Arrhythm Electrophysiol Date: 2014-09-29
Authors: Sana M Al-Khatib; William G Stevenson; Michael J Ackerman; William J Bryant; David J Callans; Anne B Curtis; Barbara J Deal; Timm Dickfeld; Michael E Field; Gregg C Fonarow; Anne M Gillis; Christopher B Granger; Stephen C Hammill; Mark A Hlatky; José A Joglar; G Neal Kay; Daniel D Matlock; Robert J Myerburg; Richard L Page Journal: Circulation Date: 2018-09-25 Impact factor: 29.690
Authors: Riina Kandolin; Jukka Lehtonen; Juhani Airaksinen; Tapani Vihinen; Heikki Miettinen; Kari Ylitalo; Kari Kaikkonen; Suvi Tuohinen; Petri Haataja; Tuomas Kerola; Jorma Kokkonen; Markus Pelkonen; Päivi Pietilä-Effati; Seppo Utrianen; Markku Kupari Journal: Circulation Date: 2014-12-19 Impact factor: 29.690
Authors: Alexander F A Androulakis; Katja Zeppenfeld; Elisabeth H M Paiman; Sebastiaan R D Piers; Adrianus P Wijnmaalen; Hans-Marc J Siebelink; Marek Sramko; Hildo J Lamb; Rob J van der Geest; Marta de Riva; Qian Tao Journal: JACC Clin Electrophysiol Date: 2019-02-27
Authors: David R Okada; John Smith; Arsalan Derakhshan; Zain Gowani; Satish Misra; Ronald D Berger; Hugh Calkins; Harikrishna Tandri; Jonathan Chrispin Journal: Circulation Date: 2018-09-18 Impact factor: 29.690
Authors: Hanna-Kaisa Nordenswan; Jukka Lehtonen; Kaj Ekström; Riina Kandolin; Piia Simonen; Mikko Mäyränpää; Tapani Vihinen; Heikki Miettinen; Kari Kaikkonen; Petri Haataja; Tuomas Kerola; Tuomas T Rissanen; Jorma Kokkonen; Aleksi Alatalo; Päivi Pietilä-Effati; Seppo Utriainen; Markku Kupari Journal: Circ Arrhythm Electrophysiol Date: 2018-08
Authors: Hiroshi Ashikaga; Tetsuo Sasano; Jun Dong; M Muz Zviman; Robert Evers; Bruce Hopenfeld; Valeria Castro; Robert H Helm; Timm Dickfeld; Saman Nazarian; J Kevin Donahue; Ronald D Berger; Hugh Calkins; M Roselle Abraham; Eduardo Marbán; Albert C Lardo; Elliot R McVeigh; Henry R Halperin Journal: Circ Res Date: 2007-10-04 Impact factor: 17.367
Authors: Tarek Zghaib; Esra G Ipek; Rozann Hansford; Hiroshi Ashikaga; Ronald D Berger; Joseph E Marine; David D Spragg; Harikrishna Tandri; Stefan L Zimmerman; Henry Halperin; Scott Brancato; Hugh Calkins; Charles Henrikson; Saman Nazarian Journal: Circ Arrhythm Electrophysiol Date: 2018-01