%0 Journal Article
%T Quantitative characterization of myocardial infarction by cardiovascular magnetic resonance predicts future cardiovascular events in patients with ischemic cardiomyopathy
%A Hajime Yokota
%A Shahriar Heidary
%A Chandra K Katikireddy
%A Patricia Nguyen
%A John M Pauly
%A Michael V McConnell
%A Phillip C Yang
%J Journal of Cardiovascular Magnetic Resonance
%D 2008
%I BioMed Central
%R 10.1186/1532-429x-10-17
%X We consecutively studied 86 patients with ICM (LVEF < 50%, mean LVEF: 26 ¡À 12%) with CMR before revascularization or medication therapy ¡À implantable cardiac defibrillator, determined the amount of myocardial scar, and followed for development of cardiovascular events. Thirty-three patients (38%) had cardiovascular events (mean follow-up: 20 ¡À 16 months). Patients who developed cardiovascular events had larger scar volume and scar percentage of the myocardium than those who did not develop cardiovascular events (16.8 ¡À 12.4 cm3 vs. 11.7 ¡À 12.6 cm3, p = 0.023 and 10.2 ¡À 6.9% vs. 7.2 ¡À 6.7%, p = 0.037, respectively). There were no significant differences in LVEDV, LVESV and LVEF between the patients with and without cardiovascular events (231 ¡À 76 ml vs. 230 ¡À 88 ml; 180 ¡À 73 ml vs. 175 ¡À 90 ml; and 25 ¡À 10% vs. 27 ¡À 13%, respectively).Quantification of the scar volume and scar percentage by CMR is superior to LVEDV, LVESV, and LVEF in prognosticating the future likelihood of the development of cardiovascular events in patients with ICM.Congestive heart failure (CHF) has become a widespread public health concern, affecting approximately 5 million patients in the United States. Over 550,000 new cases and 300,000 deaths are reported annually [1]. The most common cause of CHF is coronary artery disease. Of these, the highest mortality rate is seen in patients with ischemic cardiomyopathy (ICM) [2]. The high morbidity and mortality in CHF have been associated with a high incidence of ventricular arrhythmia and left ventricular (LV) remodelling [3,4]. Post infarction LV remodelling provides a substrate to trigger high-grade ventricular arrhythmia [5]. Specifically, areas of peri-infarct ischemia have been shown to be arrhythmogenic. It has been well known that revascularization of these ischemic territories results in a lower incidence of ventricular arrhythmia in patients with ICM [6-9]. Similarly, scar tissue has been associated with ventricular arrhythmia [10-12]. Previ
%U http://jcmr-online.com/content/10/1/17