Relationship between vectorcardiographic QRSarea, myocardial scar quantification, and response to cardiac resynchronization therapy.
J Electrocardiol
; 51(3): 457-463, 2018.
Article
em En
| MEDLINE
| ID: mdl-29454649
ABSTRACT
PURPOSE:
To investigate the relationship between vectorcardiography (VCG) and myocardial scar on cardiac magnetic resonance (CMR) imaging, and whether combining these metrics may improve cardiac resynchronization therapy (CRT) response prediction.METHODS:
Thirty-three CRT patients were included. QRSarea, Tarea and QRSTarea were derived from the ECG-synthesized VCG. CMR parameters reflecting focal scar core (Scar2SD, Gray2SD) and diffuse fibrosis (pre-T1, extracellular volume [ECV]) were assessed. CRT response was defined as ≥15% reduction in left ventricular end-systolic volume after six months' follow-up.RESULTS:
VCG QRSarea, Tarea and QRSTarea inversely correlated with focal scar (Râ¯=â¯-0.44--0.58 for Scar2SD, pâ¯≤â¯0.010), but not with diffuse fibrosis. Scar2SD, Gray2SD and QRSarea predicted CRT response with AUCs of 0.692 (pâ¯=â¯0.063), 0.759 (pâ¯=â¯0.012) and 0.737 (pâ¯=â¯0.022) respectively. A combined ROC-derived threshold for Scar2SD and QRSarea resulted in 92% CRT response rate for patients with large QRSarea and small Scar2SD or Gray2SD.CONCLUSION:
QRSarea is inversely associated with focal scar on CMR. Incremental predictive value for CRT response is achieved by a combined CMR-QRSarea analysis.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vetorcardiografia
/
Imageamento por Ressonância Magnética
/
Cicatriz
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Terapia de Ressincronização Cardíaca
/
Insuficiência Cardíaca
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Electrocardiol
Ano de publicação:
2018
Tipo de documento:
Article