title: The characteristics and distribution of the scar tissue predict ventricular tachycardia in patients with advanced heart failure.
abstract: BACKGROUND
  Contrast-enhanced magnetic resonance imaging (CMR) identifies scar tissue as hyperenhanced areas. We sought to clarify the relationship between the scar characteristics and occurrence of sustained ventricular tachycardia (VT) in patients with advanced heart failure.
  
  
  METHODS
  CMR was performed in 29 patients with dilated cardiomyopathy (DCM group) and 18 patients with ischemic cardiomyopathy (ICM group). The characteristics, volume, and distribution of the hyperenhanced areas were analyzed by CMR. The CMR parameters and clinical arrhythmic events were compared between the two groups.
  
  
  RESULTS
  In the DCM group, almost all hyperenhanced areas were nontransmural, and presented frequently in the midwall layer. The volume of the hyperenhanced areas and total number of hyperenhanced segments were greater in patients with sustained VT than in those without. On the other hand, in the ICM group, transmural or subendocardial hyperenhanced areas were detected in the territory of the coronary arteries. The volume of the hyperenhanced areas and total number of transmural hyperenhanced segments in patients with sustained VT were unexpectedly smaller than in those without. However, the percentage of nontransmural hyperenhanced segments was greater in patients with sustained VT than in those without.
  
  
  CONCLUSIONS
  The presence and magnitude of the nontransmural scar tissue may predict sustained VT in patients with advanced heart failure. There was the possibility that a recruitment bias was responsible for the finding of the smaller scars in the ICM patients with sustained VT.
authors.affiliation: Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Yokokawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tada
authors.forename: Keiko
authors.initials: K
authors.lastname: Koyama
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ino
authors.forename: Shigeki
authors.initials: S
authors.lastname: Hiramatsu
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kaseno
authors.forename: Shigeto
authors.initials: S
authors.lastname: Naito
authors.forename: Shigeru
authors.initials: S
authors.lastname: Oshima
authors.forename: Koichi
authors.initials: K
authors.lastname: Taniguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002921:Cicatrix / Q000175:diagnosis* / Q000209:etiology*; D003287:Contrast Media; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology*
chemical_list: D003287:Contrast Media