Harendra Patel, MD1, Shahriar Heidary, MD2, Hajime Yokota, MD2, Chandra Katikireddy, MD2, Patricia Nguyen, MD2, John M. Pauly, PhD3, Masahiro Terashima, MD, PhD2, Michael V. McConnell, MD, MSEE2, Phillip C. Yang, MD2
1Medicine, Stanford University, Stanford, CA, USA; 2Cardiovascular Medicine, Stanford University, Stanford, CA, USA; 3Electrical Engineering, Stanford University, Stanford, CA, USA
77 patients with ischemic cardiomyopathy (LVEF < 50%, mean LVEF: 28 15%) considered for revascularization or medications ICD were enrolled. Using a 1.5T MRI scanner, the core and border zones of infarcted myocardium were analyzed. Patients were followed for cardiovascular events: VT, VFIB, ICD firing, CHF, hospitalization, MI, repeat revascularization, syncope and death. 39 patients (39%) had events (mean follow-up: 20 16 months). The mass of the border zone rather than the core infarct was associated significantly with events (16.6 13.2 g vs. 10.7 10.1 g, p = 0.017 and 19.2 11.7 g vs. 15.0 11.6 g, p= 0.061, respectively). LVEDV, LVESV, and LVEF were not significantly different in patients with or without events. Quantitative tissue characterization of the border zone mass of infarcts is superior to core infarct mass, LVEDV, LVESV, and LVEF in prognosticating the likelihood of future cardiovascular events in patients with ICM. This CMR-guided technique may assist in clinical management of patients with ICM.
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