POSTER PRESENTATION Open Access Myocardial scar extent evaluated by cardiac magnetic resonance imaging in ICD patients: differences between polymorphic and monomorphic spontaneous events during follow-up Peter Bernhardt * , Sascha Stiller, Daniel Walcher, Wolfgang Rottbauer From 2011 SCMR/Euro CMR Joint Scientific Sessions Nice, France. 3-6 February 2011 Background Patients with ischemic cardiomyopathy have an increased risk for ventricular arrhythmia, since myocardial infarction can be the substrate for re-entrant arrhythmias. Contrast-enhanced cardiac magnetic resonance imaging (CMR) has proven to reliably quantify myocardial infarction. Aim of our study was to evaluate correlations between functional and contrast-enhanced CMR findings and spontaneous ventricular tachy- arrhythmias in patients with ischemic cardiomyopathy who underwent implantable cardioverter-defibrillator (ICD) therapy. Methods Forty-one patients with ischemic cardiomyopathy and indication for ICD therapy were examined in a 1.5-T whole-body CMR system. Cine images for quantification of left ventricular volumes and function and late gadoli- nium enhancement images for quantification of myocardial scar extent were acquired in all patients covering the entire left ventricle. Results During a follow-up period of 1184 ± 442 days 68 monomorphic and 14 polymorphic types of ventricular tachy- cardia (VT) could be observed in 12 patients. Patients with monomorphic VT had larger scar volumes (25.3 ± 11.3 vs. 11.8 ± 7.5 % of myocardial mass, p<0.05) than patients with polymorphic VT. Moreover myocardial infarction involved more segments in the LAD perfusion territory (86% vs. 20%, p<0.05) than in patients with polymorphic VT. Conclusions Patients with spontaneous monomorphic VT during the long-term follow-up period had more infarcted tissue, which was more often present in the LAD perfusion territory than patients with polymorphic events. These data strengthen the diagnostic benefit of CMR in patients with ischemic cardiomyopathy. CMR may be used for comprehensive risk stratification in patients with ischemic cardiomyopathy undergoing ICD therapy. Published: 2 February 2011 doi:10.1186/1532-429X-13-S1-P144 Cite this article as: Bernhardt et al.: Myocardial scar extent evaluated by cardiac magnetic resonance imaging in ICD patients: differences between polymorphic and monomorphic spontaneous events during follow-up. Journal of Cardiovascular Magnetic Resonance 2011 13(Suppl 1): P144. University of Ulm, Ulm, Germany Bernhardt et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P144 http://jcmr-online.com/content/13/S1/P144 © 2011 Bernhardt et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Myocardial scar extent evaluated by cardiac magnetic resonance imaging in ICD patients: differences between polymorphic and monomorphic spontaneous events during follow-up

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Page 1: Myocardial scar extent evaluated by cardiac magnetic resonance imaging in ICD patients: differences between polymorphic and monomorphic spontaneous events during follow-up

POSTER PRESENTATION Open Access

Myocardial scar extent evaluated by cardiacmagnetic resonance imaging in ICD patients:differences between polymorphic andmonomorphic spontaneous events duringfollow-upPeter Bernhardt*, Sascha Stiller, Daniel Walcher, Wolfgang Rottbauer

From 2011 SCMR/Euro CMR Joint Scientific SessionsNice, France. 3-6 February 2011

BackgroundPatients with ischemic cardiomyopathy have anincreased risk for ventricular arrhythmia, since myocar-dial infarction can be the substrate for re-entrantarrhythmias. Contrast-enhanced cardiac magnetic reso-nance imaging (CMR) has proven to reliably quantifymyocardial infarction. Aim of our study was to evaluatecorrelations between functional and contrast-enhancedCMR findings and spontaneous ventricular tachy-arrhythmias in patients with ischemic cardiomyopathywho underwent implantable cardioverter-defibrillator(ICD) therapy.

MethodsForty-one patients with ischemic cardiomyopathy andindication for ICD therapy were examined in a 1.5-Twhole-body CMR system. Cine images for quantificationof left ventricular volumes and function and late gadoli-nium enhancement images for quantification of myocar-dial scar extent were acquired in all patients coveringthe entire left ventricle.

ResultsDuring a follow-up period of 1184 ± 442 days 68 mono-morphic and 14 polymorphic types of ventricular tachy-cardia (VT) could be observed in 12 patients. Patientswith monomorphic VT had larger scar volumes (25.3 ±11.3 vs. 11.8 ± 7.5 % of myocardial mass, p<0.05) thanpatients with polymorphic VT. Moreover myocardial

infarction involved more segments in the LAD perfusionterritory (86% vs. 20%, p<0.05) than in patients withpolymorphic VT.

ConclusionsPatients with spontaneous monomorphic VT during thelong-term follow-up period had more infarcted tissue,which was more often present in the LAD perfusion ter-ritory than patients with polymorphic events. These datastrengthen the diagnostic benefit of CMR in patientswith ischemic cardiomyopathy. CMR may be used forcomprehensive risk stratification in patients withischemic cardiomyopathy undergoing ICD therapy.

Published: 2 February 2011

doi:10.1186/1532-429X-13-S1-P144Cite this article as: Bernhardt et al.: Myocardial scar extent evaluated bycardiac magnetic resonance imaging in ICD patients: differencesbetween polymorphic and monomorphic spontaneous events duringfollow-up. Journal of Cardiovascular Magnetic Resonance 2011 13(Suppl 1):P144.

University of Ulm, Ulm, Germany

Bernhardt et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):P144http://jcmr-online.com/content/13/S1/P144

© 2011 Bernhardt et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the CreativeCommons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited.

http://creativecommons.org/licenses/by/2.0