title: Detecting Regional Myocardial Abnormalities in Patients With Wolff-Parkinson-White Syndrome With the Use of ECG-Gated Cardiac MDCT.
abstract: OBJECTIVE
  Myocardial dyskinesia caused by the accessory pathway and related reversible heart failure have been well documented in echocardiographic studies of pediatric patients with Wolff-Parkinson-White (WPW) syndrome. However, the long-term effects of dyskinesia on the myocardium of adult patients have not been studied in depth. The goal of the present study was to evaluate regional myocardial abnormalities on cardiac CT examinations of adult patients with WPW syndrome.
  
  
  METHODS
  Of 74 patients with WPW syndrome who underwent cardiac CT from January 2006 through December 2013, 58 patients (mean [± SD] age, 52.2 ± 12.7 years), 36 (62.1%) of whom were men, were included in the study after the presence of combined cardiac disease was excluded. Two observers blindly evaluated myocardial thickness and attenuation on cardiac CT scans. On the basis of CT findings, patients were classified as having either normal or abnormal findings. We compared the two groups for other clinical findings, including observations from ECG, echocardiography, and electrophysiologic study.
  
  
  RESULTS
  Of the 58 patients studied, 16 patients (27.6%) were found to have myocardial abnormalities (i.e., abnormal wall thinning with or without low attenuation). All abnormal findings corresponded with the location of the accessory pathway. Patients with abnormal findings had statistically significantly decreased left ventricular function, compared with patients with normal findings (p < 0.001). The frequency of regional wall motion abnormality was statistically significantly higher in patients with abnormal findings (p = 0.043). However, echocardiography documented structurally normal hearts in all patients.
  
  
  CONCLUSIONS
  A relatively high frequency (27.6%) of regional myocardial abnormalities was observed on the cardiac CT examinations of adult patients with WPW syndrome. These abnormal findings might reflect the long-term effects of dyskinesia, suggesting irreversible myocardial injury that ultimately causes left ventricular dysfunction.
authors: 1 Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors: Hye-Jeong
authors: HJ
authors: Lee
authors: 2 Division of Cardiology, Cardiovascular Hospital, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Jae-Sun
authors: JS
authors: Uhm
authors: 2 Division of Cardiology, Cardiovascular Hospital, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Boyoung
authors: B
authors: Joung
authors: 1 Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors: Yoo Jin
authors: YJ
authors: Hong
authors: 1 Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors: Jin
authors: J
authors: Hur
authors: 1 Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors: Byoung Wook
authors: BW
authors: Choi
authors: 1 Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors: Young Jin
authors: YJ
authors: Kim
mesh_terms: D000328:Adult; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D016022:Case-Control Studies; D003287:Contrast Media; D004452:Echocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D012189:Retrospective Studies; D014927:Wolff-Parkinson-White Syndrome / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D007479:Iopamidol
keywords: Wolff-Parkinson-White syndrome; cardiac CT; myocardial hypotrophy; segmental dyskinesia; ventricular preexcitation