title: Different substrates of non-sustained ventricular tachycardia in post-infarction patients with and without left ventricular dilatation.
abstract: BACKGROUND
  We investigated the relationship between nonsustained ventricular tachycardia (NSVT) and left ventricular (LV) dilatation, function, remodeling, and scar tissue extent in patients with previous myocardial infarction (MI).
  
  
  RESULTS
  Eighty-two patients (ages 64+/-10 years) with first previous MI were referred for 24-hour electrocardiogram recording and cine and delayed enhancement (DE) cardiac magnetic resonance (CMR). LV volumes, ejection fraction, systolic wall thickening, sphericity index, and core and peri-infarctual areas of scar tissue by CMR were evaluated. LV dilatation was observed in 39 patients. Episodes of NSVT were recorded in 32 patients: 23 with LV dilatation and 9 without. In the entire population, NSVT was related to ejection fraction, LV volumes, LV mass, and sphericity index; end-systolic volume (P=.001) resulted in the only independent predictor at multivariate analysis. In patients without LV dilatation, the occurrence of NSVT was only positively related with percentage of contracting segments with DE (P=.008). Conversely, in patients with LV dilatation, increase in LV mass (P=.020) and end-systolic volume (P=.038) were independent predictors of NSVT.
  
  
  CONCLUSIONS
  Necrotic and viable myocardium coexistence within the same wall segments predicted occurrence of NSVT in patients without LV dilatation, whereas LV mass and end-systolic volume were predictors of NSVT in those with LV dilatation.
authors.affiliation: CNR, Institute of Clinical Physiology, G. Monasterio Foundation, Pisa, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Bella
authors.forename: Claudio
authors.initials: C
authors.lastname: Passino
authors.forename: Giovanni Donato
authors.initials: GD
authors.lastname: Aquaro
authors.forename: Daniele
authors.initials: D
authors.lastname: Rovai
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Strata
authors.forename: Francesco
authors.initials: F
authors.lastname: Arrigo
authors.forename: Michele
authors.initials: M
authors.lastname: Emdin
authors.forename: Massimo
authors.initials: M
authors.lastname: Lombardi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pingitore
mesh_terms: D000368:Aged; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*