Local Conduction Velocity in the Presence of Late Gadolinium Enhancement and Myocardial Wall Thinning: A Cardiac Magnetic Resonance Study in a Swine Model of Healed Left Ventricular Infarction

Jihye Jang, John Whitaker, Eran Leshem, Long H. Ngo, Ulf Neisius, Shiro Nakamori, Farhad Pashakhanloo, Bjoern Menze, Warren J. Manning, Elad Anter, Reza Nezafat*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Conduction velocity (CV) is an important property that contributes to the arrhythmogenicity of the tissue substrate. The aim of this study was to investigate the association between local CV versus late gadolinium enhancement (LGE) and myocardial wall thickness in a swine model of healed left ventricular infarction. Methods: Six swine with healed myocardial infarction underwent cardiovascular magnetic resonance imaging and electroanatomic mapping. Two healthy controls (one treated with amiodarone and one unmedicated) underwent electroanatomic mapping with identical protocols to establish the baseline CV. CV was estimated using a triangulation technique. LGE+ regions were defined as signal intensity >2 SD than the mean of remote regions, wall thinning+ as those with wall thickness <2 SD than the mean of remote regions. LGE heterogeneity was defined as SD of LGE in the local neighborhood of 5 mm and wall thickness gradient as SD within 5 mm. Cardiovascular magnetic resonance and electroanatomic mapping data were registered, and hierarchical modeling was performed to estimate the mean difference of CV (LGE+/-, wall thinning+/-), or the change of the mean of CV per unit change (LGE heterogeneity, wall thickness gradient). Results: Significantly slower CV was observed in LGE+ (0.33±0.25 versus 0.54±0.36 m/s; P<0.001) and wall thinning+ regions (0.38±0.28 versus 0.55±0.37 m/s; P<0.001). Areas with greater LGE heterogeneity (P<0.001) and wall thickness gradient (P<0.001) exhibited slower CV. Conclusions: Slower CV is observed in the presence of LGE, myocardial wall thinning, high LGE heterogeneity, and a high wall thickness gradient. Cardiovascular magnetic resonance may offer a valuable imaging surrogate for estimating CV, which may support noninvasive identification of the arrhythmogenic substrate. Visual Overview: A visual overview is available for this article.

Original languageEnglish
Article numbere007175
JournalCirculation: Arrhythmia and Electrophysiology
Volume12
Issue number5
DOIs
StatePublished - 1 May 2019
Externally publishedYes

Funding

FundersFunder number
National Institutes of HealthR01HL129157, R01HL129122
National Heart, Lung, and Blood InstituteR01HL129185
American Heart Association

    Keywords

    • conduction velocity
    • electroanatomic mapping
    • late gadolinium enhancement
    • magnetic resonance imaging
    • myocardial infarction
    • myocardial wall thickness
    • ventricular tachycardia

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