New Adjusted Cutoffs for “Normal” Endocardial Voltages in Patients With Post-Infarct LV Remodeling

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F19%3A00078515" target="_blank" >RIV/00023001:_____/19:00078515 - isvavai.cz</a>

Výsledek na webu

<a href="https://www.jacc.org/doi/pdf/10.1016/j.jacep.2019.07.007" target="_blank" >https://www.jacc.org/doi/pdf/10.1016/j.jacep.2019.07.007</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jacep.2019.07.007" target="_blank" >10.1016/j.jacep.2019.07.007</a>

Jazyk výsledku

angličtina

Název v původním jazyce

New Adjusted Cutoffs for “Normal” Endocardial Voltages in Patients With Post-Infarct LV Remodeling

Popis výsledku v původním jazyce

Objectives: This study sought to determine new reference cutoffs for normal unipolar voltage (UV) and bipolar voltage (BV) that would be adjusted for the LV remodeling. Background: The definition of “normal” left ventricular (LV) endocardial voltage in patients with post-infarct scar is still lacking. The reference voltage of the noninfarcted myocardium (NIM) may differ between patients depending on LV structural remodeling and the ensuing interstitial fibrosis. Methods: Electroanatomic voltage mapping was integrated with isotropic late gadolinium–enhanced cardiac magnetic resonance in 15 patients with nonremodeled LV and 12 patients with remodeled LV (end-systolic volume index &gt;50 ml/m2 with ejection fraction &lt;47% assessed by cardiac magnetic resonance). Reference voltages (fifth percentile values) were determined from pooled NIM segments without late gadolinium enhancement. Results: The cutoffs for normal BV and UV were ≥3.0 and ≥6.7 mV for nonremodeled LV and ≥2.1 and ≥6.4 mV for remodeled LV. Endocardial low-voltage area (LVA) defined by the adjusted cutoffs corresponded better to late gadolinium enhancement–detected scar than did LVA defined by uniform cutoffs. In 15 patients who underwent successful ablation of ventricular tachycardia, the LVA contained &gt;97% of targeted evoked delayed potentials. Insights from whole-heart T1 mapping revealed more fibrotic NIM in patients with remodeled LV compared with nonremodeled LV. Conclusions: This study found substantial differences in endocardial voltage of NIM in post-infarct patients with remodeled versus nonremodeled LV. The new adjusted cutoffs for “normal” BV and UV enable a patient-tailored approach to electroanatomic voltage mapping of LV. © 2019 American College of Cardiology Foundation

Název v anglickém jazyce

New Adjusted Cutoffs for “Normal” Endocardial Voltages in Patients With Post-Infarct LV Remodeling

Popis výsledku anglicky

Objectives: This study sought to determine new reference cutoffs for normal unipolar voltage (UV) and bipolar voltage (BV) that would be adjusted for the LV remodeling. Background: The definition of “normal” left ventricular (LV) endocardial voltage in patients with post-infarct scar is still lacking. The reference voltage of the noninfarcted myocardium (NIM) may differ between patients depending on LV structural remodeling and the ensuing interstitial fibrosis. Methods: Electroanatomic voltage mapping was integrated with isotropic late gadolinium–enhanced cardiac magnetic resonance in 15 patients with nonremodeled LV and 12 patients with remodeled LV (end-systolic volume index &gt;50 ml/m2 with ejection fraction &lt;47% assessed by cardiac magnetic resonance). Reference voltages (fifth percentile values) were determined from pooled NIM segments without late gadolinium enhancement. Results: The cutoffs for normal BV and UV were ≥3.0 and ≥6.7 mV for nonremodeled LV and ≥2.1 and ≥6.4 mV for remodeled LV. Endocardial low-voltage area (LVA) defined by the adjusted cutoffs corresponded better to late gadolinium enhancement–detected scar than did LVA defined by uniform cutoffs. In 15 patients who underwent successful ablation of ventricular tachycardia, the LVA contained &gt;97% of targeted evoked delayed potentials. Insights from whole-heart T1 mapping revealed more fibrotic NIM in patients with remodeled LV compared with nonremodeled LV. Conclusions: This study found substantial differences in endocardial voltage of NIM in post-infarct patients with remodeled versus nonremodeled LV. The new adjusted cutoffs for “normal” BV and UV enable a patient-tailored approach to electroanatomic voltage mapping of LV. © 2019 American College of Cardiology Foundation

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2019

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

JACC : Clinical electrophysiology

ISSN

2405-5018

e-ISSN

—

Svazek periodika

5

Číslo periodika v rámci svazku

10

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

12

Strana od-do

1115-1126

Kód UT WoS článku

000602734900002

EID výsledku v databázi Scopus

2-s2.0-85073117165