Skip to main content

Cardiac structural predictors of ventricular tachycardia…looking beyond ejection fraction and ventricular scar

Background

Each year, about 424,000 adults experience sudden cardiac death (SCD) in the United States. Assessment for cardiac structural anatomy is vital in this population. While left ventricular ejection fraction (LVEF) is an established predictor of ventricular tachycardia (VT), it is known that VT occurs in nonischemic patients, with normal LVEF. Contribution of ventricular scar is also under investigation. Our study aims to assess the role of newer cardiac magnetic resonance (CMR) based parameters in this population.

Methods

We performed a retrospective chart review of 49 patients who underwent CMR exams between July 2010-2012 (23 without, and 26 with sustained or nonsustained VT/ aborted SCD). Patients with ventricular tachycardia were subgrouped as patients with (11), and without (15) ventricular scar. Patients with hypertrophic cardiomyopathy were excluded from the study. All patients with VT were proven to have nonocclusive coronary artery disease by coronary angiography prior to CMR study. CMR based parameters including myocardial mass (MM), atrial scar, ventricular scar, ventricular volumes, and LVEF were recorded on these patients. Chi square test and t test were used to analyze differences between VT and control groups. Subgroup analyses included comparing the VT subgroup without ventricular scars against the controls.

Results

Our analysis suggested a higher incidence of atrial scar in patients with ventricular tachycardia 54% vs 22% in controls (c2 (1, N=49) =5.3, p = 0.037). This difference was not observed when the subgroup of VT pts without ventricular scar was compared against controls. Also, there was a trend towards a lower average MM in the VT group (146 gm ± 47) as compared to the control group (189 gm ± 102), although this difference did not reach statistical significance (t (30.32) =-1.83, p= 0.07). End diastolic, end systolic, and stroke volumes were not statistically different between the study groups.

Conclusions

The cause of VT remains obscure in 33% of patients despite imaging with echocardiography and CMR. Our study highlights the potential for using alternate CMR derived parameters such as atrial scarring as predictors of VT/SCD. Although a difference in myocardial mass between groups was not observed, the trend towards a lower MM in patients with VT is promising. Repeating the study prospectively, with more patients may explore the role of these novel parameters further.

Funding

None.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Vinayak A Hegde.

Rights and permissions

Open Access  This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.

The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Tandon, N., Apostolis, J.A., Haller, N.A. et al. Cardiac structural predictors of ventricular tachycardia…looking beyond ejection fraction and ventricular scar. J Cardiovasc Magn Reson 17, P190 (2015). https://doi.org/10.1186/1532-429X-17-S1-P190

Download citation

Keywords

  • Left Ventricular Ejection Fraction
  • Ventricular Tachycardia
  • Cardiac Magnetic Resonance
  • Sudden Cardiac Death
  • Hypertrophic Cardiomyopathy