Abstract 17887: Characteristics of Specific Heart Imaging in Survivors of Ventricular Fibrillation by 320 Slice CT
Purpose: To evaluate the characteristics of specific heart images in survivors of ventricular fibrillation (VF) by 320 slice CT.
Materials and Methods: 28 consecutive de novo survivors of VF (22 males, 64±24 yrs), referred to our institute who all had implantable cardioverter defibrillators underwent enhanced retrospective ECG gated conventional 320 slice CT (Aquilion one). Images were reconstructed every 5% from 0–95% of the R-R interval and 4 dimensional images were also reconstructed for evaluation of cardiac motion. If there were contrast defects in left ventricular (LV) myocardium (LVM) in early phase, late phase acquisition was added to evaluate abnormal late enhancement (LE), suggesting presence of fibrosis or inflammation.
Result: 17 subjects (61%) revealed normal coronary arteries and no organized heart diseases. Three (11%) had abnormal coronary arteries: 1 had significant luminal stenosis in left anterior descending branch, 1 had giant right coronary arterial aneurysm due to coronary LV fistula, and 1 had Stanford A type aortic dissection with coronary arteries from the true lumen compressed by false lumen, causing lack of blood flow and finally, acute myocardial infarction. The remaining 8 (29%) had normal coronary arteries but revealed focal abnormalities in the LVM: 3 had essential focal fibro-fatty change in LVM, 2 had focal LVM thinning and fibrosis with reduced LV motion in the lateral wall of the LV, and 1 each had normal thickened LVM with abnormal LE, suggesting inflammation finally diagnosed as acute myocarditis, Moron 2 type hypertrophic cardiomyopathy (HCM) with focal fibrosis in interventricular septum (IVS) and inferior wall of the LV and arrhythmogenic right ventricular cardiomyopathy (ARVC) with LV invasion.
Conclusion: Organized heart diseases (39% in this study) might frequently exist in survivors of VF. Macro LVM abnormalities may be especially more common than coronary arterial abnormalities in those subjects as shown by 320 slice CT.
- © 2010 by American Heart Association, Inc.