Different substrates of non-sustained ventricular tachycardia in post-infarction patients with and without left ventricular dilatation.
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.
Di Bella
Gianluca
G
CNR, Institute of Clinical Physiology, G. Monasterio Foundation, Pisa, Italy.
Passino
Claudio
C
Aquaro
Giovanni Donato
GD
Rovai
Daniele
D
Strata
Elisabetta
E
Arrigo
Francesco
F
Emdin
Michele
M
Lombardi
Massimo
M
Pingitore
Alessandro
A
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*