Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy

Atul Kapur; Goldaa Mahajan; Aprajita Kapur

doi:doi:10.11648/j.ccr.20200403.13

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Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy

Atul Kapur, Goldaa Mahajan, Aprajita Kapur

Published in Cardiology and Cardiovascular Research (Volume 4, Issue 3)

Received: 30 April 2020 Accepted: 11 June 2020 Published: 28 June 2020

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Abstract

OBJECTIVES: To determine the role of extracellular volume estimation (ECV) along with Late gadolinium enhanced (LGE) MRI in assessing viability in patients with chronic ischemic cardiomyopathy. BACKGROUND: Imaging techniques form myocardial viability estimation have shown varying results and outcomes in patients with chronic ischemic cardiomyopathy. In the current form viability estimation is being questioned as a single important prognostic prerevascularisation variable. Hence there is a need to explore new and a robust technique to achieve the above goal. METHODS: 22 consecutive patients diagnosed with chronic ischemic cardiomyopathy which were considered for bypass grafting and had angiographic proven triple vessel disease and or left main stenosis with reduced ejection fraction of <35% were enrolled in the study. CMR was done using ECV and LGE protocol. All patients had normal renal functions. Viability (V) scores and Corrected Viability (CV) scores were calculated on LGE and ECV –LGE images. Segments with ECV>50% were labeled as nonviable. Six month primary outcome measure was improved ejection fraction following revascularisation. RESULTS: Sensitivity and specificities for detection of nonviable segments on LGE and ECV-LGE were 69%, 100%and 96%, 100% with AUC’s being 0.84 and 0.98 respectively. Patients with CV score of >8 showed positive primary outcome of improved ejection fraction of 42.8% while those with CV score<8 showed a negative primary outcome. Group II patients with viable myocardium with significant fibrous tissue i.e. ECV of 28-49% showed partially improved function. CONCLUSION: Estimation of ECV-LGE method had 96% sensitivity in the detection of nonviable segments and also showed a positive primary outcome with improved ejection fraction at six months with viability being a Bayesian variable which depended upon the quantity of fibrous tissue in the viable myocardium.

Published in	Cardiology and Cardiovascular Research (Volume 4, Issue 3)
DOI	10.11648/j.ccr.20200403.13
Page(s)	92-98
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Ischemic Cardiomyopathy, Myocardial Viability, Cardiac MRI, Extra Cellular Volume

References

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APA Style

Atul Kapur, Goldaa Mahajan, Aprajita Kapur. (2020). Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy. Cardiology and Cardiovascular Research, 4(3), 92-98. https://doi.org/10.11648/j.ccr.20200403.13

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ACS Style

Atul Kapur; Goldaa Mahajan; Aprajita Kapur. Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy. Cardiol. Cardiovasc. Res. 2020, 4(3), 92-98. doi: 10.11648/j.ccr.20200403.13

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AMA Style

Atul Kapur, Goldaa Mahajan, Aprajita Kapur. Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy. Cardiol Cardiovasc Res. 2020;4(3):92-98. doi: 10.11648/j.ccr.20200403.13

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@article{10.11648/j.ccr.20200403.13,
  author = {Atul Kapur and Goldaa Mahajan and Aprajita Kapur},
  title = {Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy},
  journal = {Cardiology and Cardiovascular Research},
  volume = {4},
  number = {3},
  pages = {92-98},
  doi = {10.11648/j.ccr.20200403.13},
  url = {https://doi.org/10.11648/j.ccr.20200403.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20200403.13},
  abstract = {OBJECTIVES: To determine the role of extracellular volume estimation (ECV) along with Late gadolinium enhanced (LGE) MRI in assessing viability in patients with chronic ischemic cardiomyopathy. BACKGROUND: Imaging techniques form myocardial viability estimation have shown varying results and outcomes in patients with chronic ischemic cardiomyopathy. In the current form viability estimation is being questioned as a single important prognostic prerevascularisation variable. Hence there is a need to explore new and a robust technique to achieve the above goal. METHODS: 22 consecutive patients diagnosed with chronic ischemic cardiomyopathy which were considered for bypass grafting and had angiographic proven triple vessel disease and or left main stenosis with reduced ejection fraction of 50% were labeled as nonviable. Six month primary outcome measure was improved ejection fraction following revascularisation. RESULTS: Sensitivity and specificities for detection of nonviable segments on LGE and ECV-LGE were 69%, 100%and 96%, 100% with AUC’s being 0.84 and 0.98 respectively. Patients with CV score of >8 showed positive primary outcome of improved ejection fraction of 42.8% while those with CV score<8 showed a negative primary outcome. Group II patients with viable myocardium with significant fibrous tissue i.e. ECV of 28-49% showed partially improved function. CONCLUSION: Estimation of ECV-LGE method had 96% sensitivity in the detection of nonviable segments and also showed a positive primary outcome with improved ejection fraction at six months with viability being a Bayesian variable which depended upon the quantity of fibrous tissue in the viable myocardium.},
 year = {2020}
}

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TY  - JOUR
T1  - Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy
AU  - Atul Kapur
AU  - Goldaa Mahajan
AU  - Aprajita Kapur
Y1  - 2020/06/28
PY  - 2020
N1  - https://doi.org/10.11648/j.ccr.20200403.13
DO  - 10.11648/j.ccr.20200403.13
T2  - Cardiology and Cardiovascular Research
JF  - Cardiology and Cardiovascular Research
JO  - Cardiology and Cardiovascular Research
SP  - 92
EP  - 98
PB  - Science Publishing Group
SN  - 2578-8914
UR  - https://doi.org/10.11648/j.ccr.20200403.13
AB  - OBJECTIVES: To determine the role of extracellular volume estimation (ECV) along with Late gadolinium enhanced (LGE) MRI in assessing viability in patients with chronic ischemic cardiomyopathy. BACKGROUND: Imaging techniques form myocardial viability estimation have shown varying results and outcomes in patients with chronic ischemic cardiomyopathy. In the current form viability estimation is being questioned as a single important prognostic prerevascularisation variable. Hence there is a need to explore new and a robust technique to achieve the above goal. METHODS: 22 consecutive patients diagnosed with chronic ischemic cardiomyopathy which were considered for bypass grafting and had angiographic proven triple vessel disease and or left main stenosis with reduced ejection fraction of 50% were labeled as nonviable. Six month primary outcome measure was improved ejection fraction following revascularisation. RESULTS: Sensitivity and specificities for detection of nonviable segments on LGE and ECV-LGE were 69%, 100%and 96%, 100% with AUC’s being 0.84 and 0.98 respectively. Patients with CV score of >8 showed positive primary outcome of improved ejection fraction of 42.8% while those with CV score<8 showed a negative primary outcome. Group II patients with viable myocardium with significant fibrous tissue i.e. ECV of 28-49% showed partially improved function. CONCLUSION: Estimation of ECV-LGE method had 96% sensitivity in the detection of nonviable segments and also showed a positive primary outcome with improved ejection fraction at six months with viability being a Bayesian variable which depended upon the quantity of fibrous tissue in the viable myocardium.
VL  - 4
IS  - 3
ER  -

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Author Information

Atul Kapur

Department of Radiology, Advanced Diagnostics and Institute of Imaging 17/8, Amritsar, Punjab, India
Goldaa Mahajan

Department of Radiology, Advanced Diagnostics and Institute of Imaging 17/8, Amritsar, Punjab, India
Aprajita Kapur

Department of Radiology, Advanced Diagnostics and Institute of Imaging 17/8, Amritsar, Punjab, India

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Plain Text BibTeX RIS

APA Style

Atul Kapur, Goldaa Mahajan, Aprajita Kapur. (2020). Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy. Cardiology and Cardiovascular Research, 4(3), 92-98. https://doi.org/10.11648/j.ccr.20200403.13

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ACS Style

Atul Kapur; Goldaa Mahajan; Aprajita Kapur. Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy. Cardiol. Cardiovasc. Res. 2020, 4(3), 92-98. doi: 10.11648/j.ccr.20200403.13

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AMA Style

Atul Kapur, Goldaa Mahajan, Aprajita Kapur. Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy. Cardiol Cardiovasc Res. 2020;4(3):92-98. doi: 10.11648/j.ccr.20200403.13

Copy | Download

@article{10.11648/j.ccr.20200403.13,
  author = {Atul Kapur and Goldaa Mahajan and Aprajita Kapur},
  title = {Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy},
  journal = {Cardiology and Cardiovascular Research},
  volume = {4},
  number = {3},
  pages = {92-98},
  doi = {10.11648/j.ccr.20200403.13},
  url = {https://doi.org/10.11648/j.ccr.20200403.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20200403.13},
  abstract = {OBJECTIVES: To determine the role of extracellular volume estimation (ECV) along with Late gadolinium enhanced (LGE) MRI in assessing viability in patients with chronic ischemic cardiomyopathy. BACKGROUND: Imaging techniques form myocardial viability estimation have shown varying results and outcomes in patients with chronic ischemic cardiomyopathy. In the current form viability estimation is being questioned as a single important prognostic prerevascularisation variable. Hence there is a need to explore new and a robust technique to achieve the above goal. METHODS: 22 consecutive patients diagnosed with chronic ischemic cardiomyopathy which were considered for bypass grafting and had angiographic proven triple vessel disease and or left main stenosis with reduced ejection fraction of 50% were labeled as nonviable. Six month primary outcome measure was improved ejection fraction following revascularisation. RESULTS: Sensitivity and specificities for detection of nonviable segments on LGE and ECV-LGE were 69%, 100%and 96%, 100% with AUC’s being 0.84 and 0.98 respectively. Patients with CV score of >8 showed positive primary outcome of improved ejection fraction of 42.8% while those with CV score<8 showed a negative primary outcome. Group II patients with viable myocardium with significant fibrous tissue i.e. ECV of 28-49% showed partially improved function. CONCLUSION: Estimation of ECV-LGE method had 96% sensitivity in the detection of nonviable segments and also showed a positive primary outcome with improved ejection fraction at six months with viability being a Bayesian variable which depended upon the quantity of fibrous tissue in the viable myocardium.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Extracellular Volume Estimation in the Assessment of Myocardial Viability in Ischaemic Cardiomyopathy
AU  - Atul Kapur
AU  - Goldaa Mahajan
AU  - Aprajita Kapur
Y1  - 2020/06/28
PY  - 2020
N1  - https://doi.org/10.11648/j.ccr.20200403.13
DO  - 10.11648/j.ccr.20200403.13
T2  - Cardiology and Cardiovascular Research
JF  - Cardiology and Cardiovascular Research
JO  - Cardiology and Cardiovascular Research
SP  - 92
EP  - 98
PB  - Science Publishing Group
SN  - 2578-8914
UR  - https://doi.org/10.11648/j.ccr.20200403.13
AB  - OBJECTIVES: To determine the role of extracellular volume estimation (ECV) along with Late gadolinium enhanced (LGE) MRI in assessing viability in patients with chronic ischemic cardiomyopathy. BACKGROUND: Imaging techniques form myocardial viability estimation have shown varying results and outcomes in patients with chronic ischemic cardiomyopathy. In the current form viability estimation is being questioned as a single important prognostic prerevascularisation variable. Hence there is a need to explore new and a robust technique to achieve the above goal. METHODS: 22 consecutive patients diagnosed with chronic ischemic cardiomyopathy which were considered for bypass grafting and had angiographic proven triple vessel disease and or left main stenosis with reduced ejection fraction of 50% were labeled as nonviable. Six month primary outcome measure was improved ejection fraction following revascularisation. RESULTS: Sensitivity and specificities for detection of nonviable segments on LGE and ECV-LGE were 69%, 100%and 96%, 100% with AUC’s being 0.84 and 0.98 respectively. Patients with CV score of >8 showed positive primary outcome of improved ejection fraction of 42.8% while those with CV score<8 showed a negative primary outcome. Group II patients with viable myocardium with significant fibrous tissue i.e. ECV of 28-49% showed partially improved function. CONCLUSION: Estimation of ECV-LGE method had 96% sensitivity in the detection of nonviable segments and also showed a positive primary outcome with improved ejection fraction at six months with viability being a Bayesian variable which depended upon the quantity of fibrous tissue in the viable myocardium.
VL  - 4
IS  - 3
ER  -

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