Relations between structural changes in the myocardium and rhythm disturbance in patients with chronic myocardial infraction.

Mironova N.A., Yeghiazaryan L.H., Aparina O.P., Butorova E.A., Stukalova O.V.

Purpose. To study the relationship between structural changes in the myocardium and ventricular rhythm disturbance (VRD) in patients with chronic myocardial infarction (CMI). Materials and methods. The study included over the 26 patients with CMI, mean age - 62 [54; 68] y/o, who had VRD Laun 2 or more. Surface non-invasive epi- and endocardial mapping (NIEEC) of the heart with multichannel recording system of electrocardiograms using the Amicard 01c system, high-resolution delayed enhancement cardiac MRI (1,25х1,25х2,5mm) was performed in all patients. Results. The number of premature ventricular contraction (PVC) per day in the group was 6233 [1185, 11978]. There were documented episodes of stable ventricular tachycardia (VT) in 8 patient. According to the NIEEC, in all cases the predominant morphological type of PVC originated from the LV. The volume of fibrosis was 7.75% [4.3; 18.5], heterogeneous tissue (HT) - 7.3% [5.5; 10.3]. It was established that the predominance of the portion of HT over the portion of fi-brosis in the myocardium of the LV correlated with the total number (r = 0.51, p = 0.05), single PVC (r = 0.52, p = 0.05), the presence of a stable VT (r = -0.4, p = 0.05). It was estab-lished that 73% of the cases PVC generated from the scar area. The amount of fibrosis in the LV myocardium > to 14.7% with a sensitivity of 62.5% and specificity of 77.8 per cent were associated VT. The value of a share of fibrosis and het-erogeneous tissue of 0.87 with a sensitivity of 87.5% and a specificity of 61 was also associ-ated with VT. Conclusions. In all patients, the scar area had a non-uniform character. The severity of fibrosis and heterogeneous tissue was associated with the severity of ventricular ar-rhythmias. In most patients with CMI source of the predominant type of PVCs was scar tis-sue. The heterogeneity of the scar tissue ̶ an important factor for the development of ma-lignant arrhythmias.
A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research Center. Moscow, Russia.







Keywords: ventricular arrhythmias, myocardial infarction, heterogeneous tissue, fibrosis, late enhancement MRI.


Corresponding author:Mironova Natalia, e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: : Harmeet S. Dhillon, Serova N.S. Vesico-vaginal reflux. REJR. 2017; 7 (2):158-167. DOI:10.21569/2222 -7415-2017-67-2-158-167./em>

Received: 17.07.2017 Accepted:04.09.2017