Scar border zone mass and presence of border zone channels assessed with cardiac magnetic resonance imaging are associated with ventricular arrhythmia in patients with ST-segment elevation myocardial infarction
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Scar border zone mass and presence of border zone channels assessed with cardiac magnetic resonance imaging are associated with ventricular arrhythmia in patients with ST-segment elevation myocardial infarction. / Thomsen, Anna F.; Bertelsen, Litten; Jøns, Christian; Jabbari, Reza; Lønborg, Jacob; Kyhl, Kasper; Göransson, Christoffer; Nepper-Christensen, Lars; Atharovski, Kiril; Ekström, Kathrine; Tilsted, Hans Henrik; Pedersen, Frants; Køber, Lars; Engstrøm, Thomas; Vejlstrup, Niels; Jacobsen, Peter Karl.
I: Europace, Bind 25, Nr. 3, 2023, s. 978-988.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Scar border zone mass and presence of border zone channels assessed with cardiac magnetic resonance imaging are associated with ventricular arrhythmia in patients with ST-segment elevation myocardial infarction
AU - Thomsen, Anna F.
AU - Bertelsen, Litten
AU - Jøns, Christian
AU - Jabbari, Reza
AU - Lønborg, Jacob
AU - Kyhl, Kasper
AU - Göransson, Christoffer
AU - Nepper-Christensen, Lars
AU - Atharovski, Kiril
AU - Ekström, Kathrine
AU - Tilsted, Hans Henrik
AU - Pedersen, Frants
AU - Køber, Lars
AU - Engstrøm, Thomas
AU - Vejlstrup, Niels
AU - Jacobsen, Peter Karl
N1 - Publisher Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2023
Y1 - 2023
N2 - Aims Late gadolinium enhancement cardiac magnetic resonance (CMR) permits characterization of left ventricular ischaemic scars. We aimed to evaluate if scar core mass, border zone (BZ) mass, and BZ channels are risk markers for subsequent ventricular arrhythmia (VA) in ST-segment elevation myocardial infarction (STEMI) Methods A sub-study of the DANish Acute Myocardial Infarction-3 multi-centre trial and Danegaptide phase II proof-of-concept clin- and results ical trial in which a total of 843 STEMI patients had a 3-month follow-up CMR. Of these, 21 patients subsequently experienced VA during 100 months of follow-up and were randomly matched 1:5 with 105 controls. A VA event was defined as: ventricular tachycardia, ventricular fibrillation, or sudden cardiac death. Ischaemic scar characteristics were automatically detected by specialized software. We included 126 patients with a median left ventricular ejection fraction of 51.0 ± 11.6% in cases with VA vs. 55.5 ± 8.5% in controls (P = 0.10). Cases had a larger mean BZ mass and more often BZ channels compared to controls [BZ mass: 17.2 ± 10.3 g vs. 10.3 ± 6.0 g; P = 0.0002; BZ channels: 17 (80%) vs. 44 (42%); P = 0.001]. A combination of ≥17.2 g BZ mass and the presence of BZ channels was five times more prevalent in cases vs. controls (P ≤ 0.00001) with an odds ratio of 9.40 (95% confidence interval 3.26–27.13; P ≤ 0.0001) for VA. This identified cases with 52% sensitivity and 90% specificity Conclusion(s) Scar characterization with CMR indicates that a combination of ≥17.2 g BZ mass and the presence of BZ channels had the strongest association with subsequent VA in STEMI patients ClinicalTrials.gov Unique identifier: NCT01435408 (DANAMI 3-iPOST and DANAMI 3-DEFER), NCT01960933 (DANAMI 3-PRIMULTI), and NCT01977755 (Danegaptide).
AB - Aims Late gadolinium enhancement cardiac magnetic resonance (CMR) permits characterization of left ventricular ischaemic scars. We aimed to evaluate if scar core mass, border zone (BZ) mass, and BZ channels are risk markers for subsequent ventricular arrhythmia (VA) in ST-segment elevation myocardial infarction (STEMI) Methods A sub-study of the DANish Acute Myocardial Infarction-3 multi-centre trial and Danegaptide phase II proof-of-concept clin- and results ical trial in which a total of 843 STEMI patients had a 3-month follow-up CMR. Of these, 21 patients subsequently experienced VA during 100 months of follow-up and were randomly matched 1:5 with 105 controls. A VA event was defined as: ventricular tachycardia, ventricular fibrillation, or sudden cardiac death. Ischaemic scar characteristics were automatically detected by specialized software. We included 126 patients with a median left ventricular ejection fraction of 51.0 ± 11.6% in cases with VA vs. 55.5 ± 8.5% in controls (P = 0.10). Cases had a larger mean BZ mass and more often BZ channels compared to controls [BZ mass: 17.2 ± 10.3 g vs. 10.3 ± 6.0 g; P = 0.0002; BZ channels: 17 (80%) vs. 44 (42%); P = 0.001]. A combination of ≥17.2 g BZ mass and the presence of BZ channels was five times more prevalent in cases vs. controls (P ≤ 0.00001) with an odds ratio of 9.40 (95% confidence interval 3.26–27.13; P ≤ 0.0001) for VA. This identified cases with 52% sensitivity and 90% specificity Conclusion(s) Scar characterization with CMR indicates that a combination of ≥17.2 g BZ mass and the presence of BZ channels had the strongest association with subsequent VA in STEMI patients ClinicalTrials.gov Unique identifier: NCT01435408 (DANAMI 3-iPOST and DANAMI 3-DEFER), NCT01960933 (DANAMI 3-PRIMULTI), and NCT01977755 (Danegaptide).
KW - Cardiac magnetic resonance Late gadolinium enhancement Scar ST-segment elevation myocardial infarction Ventricular arrhythmia
U2 - 10.1093/europace/euac256
DO - 10.1093/europace/euac256
M3 - Journal article
C2 - 36576342
AN - SCOPUS:85171772694
VL - 25
SP - 978
EP - 988
JO - Europace
JF - Europace
SN - 1099-5129
IS - 3
ER -
ID: 397028705