Abstract

Sudden cardiac death (SCD) accounts for 20% of all deaths in the western world and is usually due to malignant ventricular tachycardia and fibrillation (VT/VF). There is currently no non-invasive method to assess risk of future VT. Ventricular arrhythmias usually occur due to scar tissue that borders with surviving myocardial muscle in an area designated as the arrhythmogenic scar zone to distinguish it from non-arrhythmogenic scar that does not give rise to arrhythmias. Arrhythmogenic scar has a unique structural and electrical signature that has been established in ex-vivo human specimens from patients undergoing heart transplant. However, in-vivo techniques to identify arrhythmogenic scar are limited. Invasive electrophysiological (EP) signal recordings using catheter mapping has been used for identifying patient at risk of developing malignant arrhythmia. However due to low resolution of mapping catheter, long and high risk invasive procedure, and low sensitivity and specificity, it is not clinically used to distinguish arrhythmogenic from non-arrhythmogenic scar tissue. The overall aim of this study is to non-invasively identify arrhythmogenic scar tissue using MRI by exploiting two novel technologies 1) very high-resolution scar imaging using MRI and 2) high-resolution catheter mapping. We hypothesize that the area of normal myocardium surrounded by dense scar region in 3D high-resolution scar MRI is a hallmark of arrhythmogenic scar tissue in a swine model of infarct related VT.

Public Health Relevance

Sudden cardiac death (SCD) accounts for 20% of all deaths in the western world and is usually due to malignant ventricular tachycardia and fibrillation (VT/VF). There is currently no non-invasive method to assess risk of future VT. The overall aim of this study is to non-invasively identify arrhythmogenic scar tissue using MRI. We hypothesize that the area of normal myocardium surrounded by dense scar region in 3D high- resolution LGE is a hallmark of arrhythmogenic scar tissue in a swine model of infarct related VT.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21HL127650-02
Application #
9031814
Study Section
Electrical Signaling, Ion Transport, and Arrhythmias Study Section (ESTA)
Program Officer
Desvigne-Nickens, Patrice
Project Start
2015-03-10
Project End
2017-02-28
Budget Start
2016-03-01
Budget End
2017-02-28
Support Year
2
Fiscal Year
2016
Total Cost
Indirect Cost

  Institution

Name
Beth Israel Deaconess Medical Center
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code

  Publications

Nakamori, Shiro; Bui, An H; Jang, Jihye et al. (2018) Increased myocardial native T1 relaxation time in patients with nonischemic dilated cardiomyopathy with complex ventricular arrhythmia. J Magn Reson Imaging 47:779-786
Fahmy, Ahmed S; Rausch, Johannes; Neisius, Ulf et al. (2018) Automated Cardiac MR Scar Quantification in Hypertrophic Cardiomyopathy Using Deep Convolutional Neural Networks. JACC Cardiovasc Imaging 11:1917-1918
El-Rewaidy, Hossam; Nezafat, Maryam; Jang, Jihye et al. (2018) Nonrigid active shape model-based registration framework for motion correction of cardiac T1 mapping. Magn Reson Med 80:780-791
Fahmy, Ahmed S; Neisius, Ulf; Tsao, Connie W et al. (2018) Gray blood late gadolinium enhancement cardiovascular magnetic resonance for improved detection of myocardial scar. J Cardiovasc Magn Reson 20:22
Nakamori, Shiro; Ismail, Haisam; Ngo, Long H et al. (2017) Left ventricular geometry predicts ventricular tachyarrhythmia in patients with left ventricular systolic dysfunction: a comprehensive cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 19:79
Nakamori, Shiro; Alakbarli, Javid; Bellm, Steven et al. (2017) Native T1 value in the remote myocardium is independently associated with left ventricular dysfunction in patients with prior myocardial infarction. J Magn Reson Imaging 46:1073-1081
Basha, Tamer A; Akçakaya, Mehmet; Liew, Charlene et al. (2017) Clinical performance of high-resolution late gadolinium enhancement imaging with compressed sensing. J Magn Reson Imaging 46:1829-1838
Leshem, Eran; Tschabrunn, Cory M; Contreras-Valdes, Fernando M et al. (2017) Evaluation of ablation catheter technology: Comparison between thigh preparation model and an in vivo beating heart. Heart Rhythm 14:1234-1240
Jang, Jihye; Bellm, Steven; Roujol, Sébastien et al. (2016) Comparison of spoiled gradient echo and steady-state free-precession imaging for native myocardial T1 mapping using the slice-interleaved T1 mapping (STONE) sequence. NMR Biomed 29:1486-96
Bellm, Steven; Basha, Tamer A; Shah, Ravi V et al. (2016) Reproducibility of myocardial T1 and T2 relaxation time measurement using slice-interleaved T1 and T2 mapping sequences. J Magn Reson Imaging 44:1159-1167

Showing the most recent 10 out of 20 publications