title: Risk of ventricular arrhythmia in patients with myocardial infarction and non-obstructive coronary arteries and normal ejection fraction.
abstract: OBJECTIVE
  To assess the arrhythmic determinants and prognosis of patients presenting with myocardial infarction and non-obstructive coronary arteries (MINOCA) with normal ejection fraction (EF).
  
  
  METHODS
  This is an observational analysis of 131 MINOCA patients with normal EF. Three cardiac magnetic resonance (CMR) diagnosis classes were recognized according to the late gadolinium enhancement (LGE) pattern: Myocardial infarction (MI) (n= 34), myocarditis (n= 47), and "no LGE" (n= 50). Ventricular events occurring during hospitalization were recorded and the entire population was followed-up at 1 year.
  
  
  RESULTS
  Ventricular arrhythmia was observed in 18 (13.8%) patients during hospitalization. The "no LGE" patients experienced fewer ventricular events than the MI and myocarditis patients [4.0%vs26.5% and 14.9%, respectively (P= 0.013)]. There was no significant difference between the MI and myocarditis groups. On multivariate analysis, LGE transmural extent [OR = 1.52 (1.08-2.15),P= 0.017] and ST-segment elevation [OR = 4.65 (1.61-13.40),P= 0.004] were independent predictors of ventricular arrhythmic events, irrespective of the diagnosis class. Finally, no patient experienced sudden cardiac death or ventricular arrhythmia recurrence at 1-year.
  
  
  CONCLUSIONS
  MINOCA patients with normal EF presented no 1-year cardiovascular events, irrespective of the CMR diagnosis class. LGE transmural extent and ST segment elevation at admission are risk markers of ventricular arrhythmia during hospitalization.
authors.affiliation: Loïc Bière, Marjorie Niro, Fabrice Prunier, Alain Furber, Laboratoire Cardioprotection, Institut MITOVASC, Remodelage et Thrombose, Service de Cardiologie, CHU d'Angers, F-49045 Angers, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Bière
authors.affiliation: Loïc Bière, Marjorie Niro, Fabrice Prunier, Alain Furber, Laboratoire Cardioprotection, Institut MITOVASC, Remodelage et Thrombose, Service de Cardiologie, CHU d'Angers, F-49045 Angers, France.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Niro
authors.affiliation: Loïc Bière, Marjorie Niro, Fabrice Prunier, Alain Furber, Laboratoire Cardioprotection, Institut MITOVASC, Remodelage et Thrombose, Service de Cardiologie, CHU d'Angers, F-49045 Angers, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Pouliquen
authors.affiliation: Loïc Bière, Marjorie Niro, Fabrice Prunier, Alain Furber, Laboratoire Cardioprotection, Institut MITOVASC, Remodelage et Thrombose, Service de Cardiologie, CHU d'Angers, F-49045 Angers, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Gourraud
authors.affiliation: Loïc Bière, Marjorie Niro, Fabrice Prunier, Alain Furber, Laboratoire Cardioprotection, Institut MITOVASC, Remodelage et Thrombose, Service de Cardiologie, CHU d'Angers, F-49045 Angers, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Prunier
authors.affiliation: Loïc Bière, Marjorie Niro, Fabrice Prunier, Alain Furber, Laboratoire Cardioprotection, Institut MITOVASC, Remodelage et Thrombose, Service de Cardiologie, CHU d'Angers, F-49045 Angers, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Furber
authors.affiliation: Loïc Bière, Marjorie Niro, Fabrice Prunier, Alain Furber, Laboratoire Cardioprotection, Institut MITOVASC, Remodelage et Thrombose, Service de Cardiologie, CHU d'Angers, F-49045 Angers, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Probst
keywords: Cardiac magnetic resonance; Late gadolinium enhancement; Myocardial infarction; Myocardial infarction and non-obstructive coronary arteries; Myocarditis; Ventricular tachycardia