Diffuse Ventricular Fibrosis Is a Late Outcome of Tachycardia-Mediated Cardiomyopathy After Successful Ablation

Ling, Liang‐Han; Kalman, Jonathan M.; Ellims, A.; Iles, Leah M.; Medi, Caroline; Sherratt, C.; Kaye, David M.; Hare, James L.; Kistler, Peter M.; Taylor, Andrew J.

doi:10.1161/circep.113.000681

Cited by 69 publications

(51 citation statements)

References 50 publications

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“…Ling et al reported that no LGE was observed in 18 TIC patients who underwent CMR 5 years after their treatment of atrial-TIC. 37 The same authors also reported that in 16 AF patients without LGE, all patients had normalized ventricular function following the restoration of sinus rhythm. 44 However, the prevalence of LGE in TIC caused by atrial arrhythmias was not examined in those studies.…”

Section: Evaluation Of the Myocardial Substrate Using Cmrmentioning

confidence: 86%

“…37 Histological reports have shown mild myocardial hypertrophy and fibrosis in endomyocardial biopsies from TIC patients. 38- 40 Although LGE and T1 mapping using CMR have emerged as novel tools to assess myocardial fibrosis, 41,42 data regarding the prevalence and characteristics of LGE in TIC are limited.…”

Section: Evaluation Of the Myocardial Substrate Using Cmrmentioning

confidence: 99%

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Diagnostic Value of Right Ventricular Dysfunction in Tachycardia-Induced Cardiomyopathy Using Cardiac Magnetic Resonance Imaging

Okada

Nakajima

Morita

et al. 2016

Circ J

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Background: Predicting tachycardia-induced cardiomyopathy (TIC) in patients presenting with left ventricular (LV) dysfunction and tachyarrhythmias remains challenging. We assessed the diagnostic value of early right ventricular (RV) dysfunction to predict TIC using cardiac magnetic resonance (CMR) imaging. Methods and Results:A total of 102 consecutive patients with newly diagnosed LV dysfunction and atrial tachyarrhythmias were examined. Patients whose LV ejection fraction (EF) improved to ≥50% during a 1-year follow-up were diagnosed with TIC, and with dilated cardiomyopathy (DCM) in those whose did not improve. CMR was performed at a median of 23 days after admission, and the TIC and DCM patients exhibited different distributions of EF and end-diastolic volume (EDV) between the LV and RV (both P<0.001, ANCOVA). TIC patients had significantly lower RVEF/LVEF ratio (1.01±0.23 vs. 1.36±0.31, P<0.001) and higher RVEDV/LVEDV ratio (0.96±0.21 vs. 0.73±0.19, P<0.001) compared with DCM patients, suggesting that RV systolic dysfunction and RV dilatation were observed in TIC. In the multivariate analysis, age, RVEF/LVEF ratio, and RVEDV/LVEDV ratio were significant predictors of TIC, and RVEF/LVEF ratio of <1.05 most highly predicted TIC with a sensitivity of 69.1% and specificity of 91.5% (area under the curve 0.860). Conclusions:Among patients with newly diagnosed LV dysfunction and atrial tachyarrhythmias, age and coexistence of RV dysfunction was a strong predictor of TIC. (Circ J 2016; 80: 2141 -2148

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Section: Evaluation Of the Myocardial Substrate Using Cmrmentioning

confidence: 86%

Section: Evaluation Of the Myocardial Substrate Using Cmrmentioning

confidence: 99%

Diagnostic Value of Right Ventricular Dysfunction in Tachycardia-Induced Cardiomyopathy Using Cardiac Magnetic Resonance Imaging

Okada

Nakajima

Morita

et al. 2016

Circ J

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“…Tachycardia-mediated cardiomyopathy patients exhibited differences in LV structure and function including diffuse fibrosis long after arrhythmia cure, indicating that recovery was incomplete [51].…”

Section: Tachycardia-induced Cardiomyopathymentioning

confidence: 99%

The Prognostic Role of T1 Mapping Sequences: Can T1 Mapping Parameters Have a Role in Risk Stratification?

Choi

Park

Kim

2017

Cardiovasc Imaging Asia

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Cardiovascular disease risk stratification and prognostication are very important for treatment planning. In addition, for a growing number of patients with overt symptomatic heart failure or asymptomatic but have structural heart disease, accurate risk stratification is essential. Conventional clinical cardiovascular risk factors, several biomarkers and echo-Doppler indexes are generally used to satisfy this need. However, non-invasive approaches to direct structural and tissue characterization of the myocardium have not produced satisfactory results. The recent development of the late gadolinium enhancement (LGE) imaging allows fibrosis or myocardial inflammation to be visualized. A growing body of evidence for LGEbased prognostication has been reported. However, not all patients with heart failure or at risk for it have been assessed with LGE. Moreover, the degree of diffuse fibrosis or inflammation cannot be easily quantified with LGE techniques. Recently, introduced T1 mapping-based quantification can provide the volume of extracellular space suggestive of the degree of diffuse tissue fibrosis or inflammation. Even without gadolinium contrast, native T1 values can provide quantitative information on myocardial tissue status. Here, we review current evidence for T1 mapping-based risk stratification and prognostication for various cardiac diseases that can lead to heart failure or lethal arrhythmic events.

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“…51 However, in patients with long-standing tachycardia-induced cardiomyopathy, echocardiographic evaluations following resolution of the causal arrhythmia showed persistence of elevated stroke volumes and LV end-systolic and end-diastolic volumes, as well as diffuse fibrosis at contrast magnetic resonance imaging, suggesting persistent maladaptive remodeling. 52,53 A common cause of TIC is persistent atrial tachycardia or accessory pathway mediated supraventricular tachycardias. These are eminently amenable to ablation and there are a number of pediatric and adult case series highlighting the benefits of treatment.…”

Section: Reviewmentioning

confidence: 99%

Reversible Dilated Cardiomyopathy: Into the Thaumaturgy of the Heart—Part 1

et al. 2016

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Dilated cardiomyopathy (DCM) is a genetic or acquired heart muscle disorder characterized by dilation and impaired contraction of one or both ventricles. In the acquired forms of the disease, if the pathogenic agent is persistent, undiagnosed or untreated, permanent ultrastructural and morphological changes may lead to irreversible dysfunction. Conversely, when DCM is promptly recognized and treated, the heart may show an extraordinary ability to recover from left ventricular (LV) systolic dysfunction. While much research in heart failure has focused on morbidity and mortality associated with persistent LV systolic dysfunction, relatively little attention has been devoted to this remarkable potential for recovery. In this two-part review we will focus on the most common types of reversible DCM. The first part will deal with Tako-Tsubo cardiomyopathy, tachycardiainduced cardiomyopathy, metabolic DCM and recovery after Left ventricular assist device implantation. Although diverse in etiopathogenesis, genetic background, therapeutic options and outcome, the forms of DCM characterized by reversible LV dysfunction share similar challenges in diagnosis and clinical management. The identification of pathways to recovery may show the way for novel therapeutic targets ultimately benefitting all cardiac patients.

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Diffuse Ventricular Fibrosis Is a Late Outcome of Tachycardia-Mediated Cardiomyopathy After Successful Ablation

Cited by 69 publications

References 50 publications

Diagnostic Value of Right Ventricular Dysfunction in Tachycardia-Induced Cardiomyopathy Using Cardiac Magnetic Resonance Imaging

Diagnostic Value of Right Ventricular Dysfunction in Tachycardia-Induced Cardiomyopathy Using Cardiac Magnetic Resonance Imaging

The Prognostic Role of T1 Mapping Sequences: Can T1 Mapping Parameters Have a Role in Risk Stratification?

Reversible Dilated Cardiomyopathy: Into the Thaumaturgy of the Heart—Part 1

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