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Myocardial fibrosis tied to ventricular arrhythmias By Reuters Health April 11, 2008
NEW YORK (Reuters Health), Apr 11 - The results of cardiac magnetic resonance imaging (MRI) studies in patients with hypertrophic cardiomyopathy, but few symptoms, indicate that myocardial fibrosis is associated with ventricular tachyarrhythmias, researchers report in the April 8 issue of the Journal of the American College of Cardiology.
The study, lead investigator Dr. A. Selcuk Adabag told Reuters Health, "provides direct evidence that myocardial fibrosis detected in vivo by cardiac MRI is arrhythmogenic. This paves the way for a long-term study for establishing delayed enhancement on cardiac MRI as a risk factor for sudden death in hypertrophic cardiomyopathy."
Dr. Adabag of the Veterans Affairs Medical Center, Minneapolis, and colleagues came to this conclusion after studying 177 hypertrophic cardiomyopathy patients who had no or few symptoms. All underwent 24-hour Holter electrocardiogram monitoring.
Patients with delayed enhancement on MRI, representing areas of myocardial fibrosis, were significantly more likely to have premature ventricular contractions (89% versus 72%). This was also true of couplets and nonsustained ventricular tachycardia. These patients also had greater number of such events.
Delayed enhancement was an independent predictor of nonsustained ventricular tachycardias (relative risk, 7.3). However, the extent of delayed enhancement was similar in patients with and without premature ventricular arrhythmias.
Dr. Saman Nazarian, co-author of an accompanying editorial told Reuters Health that based on previous studies, he and his colleagues "believe that MRI can complement existing methods for arrhythmia risk stratification of patients with myocardial dysfunction due to nonischemic cardiomyopathy."
Dr. Nazarian of Johns Hopkins Hospital, Baltimore, added that the results of the current study "are very promising and suggest that risk stratification via MRI may be applicable to other high-risk patient groups."
NEW YORK (Reuters Health), Apr 11 - The results of cardiac magnetic resonance imaging (MRI) studies in patients with hypertrophic cardiomyopathy, but few symptoms, indicate that myocardial fibrosis is associated with ventricular tachyarrhythmias, researchers report in the April 8 issue of the Journal of the American College of Cardiology.
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