Cardiac magnetic resonance characteristics in young survivors of aborted sudden cardiac death. Issue 105 (August 2018)

• Record Type: Journal Article
• Authors: Zaremba, Tomas; Brøndberg, Anders Krogh; Jensen, Henrik Kjærulf; Kim, Won Yong
• Is Part Of: European journal of radiology. Issue 105(2018)
• Page Start: 141
• Page End: 147
• Publication Date: 2018-08
• Subjects: AHA American Heart Association -- aSCD aborted sudden cardiac death -- ATP anti-tachycardia pacing -- CMR cardiovascular magnetic resonance scanning -- CHD coronary heart disease -- CPVT catecholaminergic polymorphic ventricular tachycardia -- ECG electrocardiogram -- EDd end-diastolic diameter -- EF ejection fraction -- ICC intraclass correlation coefficient -- ICD implantable cardioverter defibrillator -- IQR interquartile range -- LGE late gadolinium enhancement -- LV left ventricle -- RV right ventricle -- SCD sudden cardiac death -- SSFP steady-state free precession -- SR strain rate -- TAPSE tricuspidal annular plane systolic excursion -- VF ventricular fibrillation -- VT ventricular tachycardia; CMR -- Cardiomyopathies -- Arrhythmic syndromes -- Sudden cardiac death -- Ventricular arrhythmias; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2018.06.004
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Cardiovascular magnetic resonance characteristics of young survivors of non-ischaemic SCD are limited. Idiopathic ventricular tachycardia/ventricular fibrillation is the most prevalent condition in young survivors of SCD. As structural and functional abnormalities in survivors of non-ischaemic SCD are minimal, prognostication of SCD by CMR remains challenging. Abstract: Purpose: We aimed to identify and assess cardiac abnormalities by cardiovascular magnetic resonance (CMR) in a non-ischaemic aborted sudden cardiac death (SCD) population and to establish possible predictors of SCD. Methods: Thirty-six consecutive SCD survivors [median age 37.6 years (IQR 24.1-43.2), 31% female] with no previous cardiac history or evidence of ischaemic heart disease underwent CMR on day 6 (IQR 4-10) after admission. Data on ventricular volumes and the extent of late gadolinium enhancement (LGE) were collected. Systolic strain analysis was performed using feature tracking software. Results: Left ventricular (LV) and right ventricular (RV) indexed diastolic volumes were 92.9 ± 28.4 ml/m 2 and 94.1 ± 29 ml/m 2, respectively. LV ejection fraction (EF) and RV EF were 56.8 ± 10.7% and 53.7 ± 10.7%, respectively. Global peak endocardial longitudinal, circumferential, and radial strain were −17.9 ± 4.28%, −23.2 ± 5.8%, and 32.8 ± 10.6%, respectively. Compared to normal range, global longitudinal endocardial strain, longitudinal epicardial strain, circumferential endocardial strain, radial strain, and circumferential endocardial strain rate were impaired. Median volume of LGE was 0.25% (IQR 0.12-1.12) of the LV myocardium with highest prevalence in the inferolateral wall. Patients with cardiomyopathy diagnosis (n = 16) had lower LV strain rate compared to patients without cardiomyopathy (n = 20). Conclusions: CMR findings in young patients with aborted SCD due to non-ischaemic heart disease seem to be minor. Although only present in small amounts, LGE appears to have a predilection towards the inferolateral wall in this population.