Email this article CONCORDANCE OF ELECTROPHYSIOLOGICAL AND PERFUSION ABNORMALITIES IN THE LEFT VENTRICULAR MYOCARDIUM IN POST INFARCTION ANEURYSMS WITH VENTRICULAR TACHYCARDIA
- Authors: Babokin V.E.1, Minin S.M.2, Gutor S.S.3, Batalov R.E.4, Shipulin V.M.4, Lishmanov Y.B.4, Popov S.V.4, Karpov R.S.4
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Affiliations:
- Moscow Regional Research and Clinical Institute (MONIKI)
- Novosibirsk Scientific Research Institute of Blood Circulation Pathology named after E.N. Meshalkin
- Siberian Medical State University
- Research Institute for Сardiology
- Issue: No 38 (2015)
- Pages: 11-18
- Section: ARTICLES
- URL: https://almclinmed.ru/jour/article/view/263
- DOI: https://doi.org/10.18786/2072-0505-2015-38-11-18
- ID: 263
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Abstract
Background: Ventricular tachycardia in patients with post infarction aneurysm of the left ventricle (LV) suggests the presence of myocardial perfusion abnormalities.
Aim: To determine a relationship between electrophysiological and perfusion abnormalities inLV myocardium in patients with coronary heart disease, post infarction aneurysms and ventricular tachycardia.
Materials and methods: We assessed 23 patients with post infarctionLV aneurysms who were candidates for surgical removal of the aneurysm and/or coronary artery bypass grafting. Methods of assessment included intracardiac electrophysiology study (EPS) with a 3D electro-anatomical reconstruction ofLV, as well as perfusional one-photon emission computer tomography of the myocardium with 99mTc-Technetril.
Results: In most (68%) ofLV segments with normal electrical conductivity (electric potential magnitude above 1.5 mV, EPS group 1), myocardial perfusion exceeded 70% (accumulation of the radionuclide agent in percentages from maximal myocardial uptake). The transitional zone segments (electric potential magnitude of 0.5–1.5 mV, EPS group 2) comprised equal (18% each) in the zones with low perfusion proportions (31–69% and 45–54%). Most (52%) segments with “electrophysiological scar” (electric potential magnitude below 0.5 мВ, EPS group 3) were in the zone with no perfusion (< 30%). Segments with zero conductivity (EPS group 4) were located also in the zone with no perfusion and partially (20%) in the hypoperfusion (up to 44%) zone. Assessment of perfusion percentage in each individual segment showed that EPS group 1 segments were perfused at 61% (48–71%) of maximal LV myocardial perfusion, EPS group 2 segments, at 45% (34–56%), EPS group 3 segments, at 35% (30–46%), and EPS group 4 segments, at 26% (21–31%). In all patients groups, there was a significant correlation with myocardial perfusion on the semiuantitative scale (i.e., perfusion groups from 0 to 4) (V = 93.5; p < 0,001), as well as negative correlation on the quantitative scale (r = -0,56; p < 0,001), thereby demonstrating that segments with higher perfusion have higher probability to be in EPS group 1.
Conclusion: Electrophysiological characteristics ofLV depend on myocardial perfusion. Electrophysiologically normal myocardium with electric potential above 1.5 mV, the transitional zone (0.5–1.5 mV) and the zone with potential of < 0.5 mV differ significantly in their perfusion percentages (61, 45 and 35%, respectively).
About the authors
V. E. Babokin
Moscow Regional Research and Clinical Institute (MONIKI)
Author for correspondence.
Email: babokin@bk.ru
PhD, Head of Department of Cardiac Surgery
Russian FederationS. M. Minin
Novosibirsk Scientific Research Institute of Blood Circulation Pathology named after E.N. Meshalkin
Email: fake@neicon.ru
PhD, Head of Department of Radioisotope Diagnostics of the Division of Radiology and Functional Diagnostics
Russian FederationS. S. Gutor
Siberian Medical State University
Email: fake@neicon.ru
Assistant Lecturer, Chair of Morphology and General Pathology
Russian FederationR. E. Batalov
Research Institute for Сardiology
Email: fake@neicon.ru
PhD, Senior Research Fellow, Department of Surgical Treatment of Complex Heart Arrythmias and Electrical Cardiac Stimulation
Russian FederationV. M. Shipulin
Research Institute for Сardiology
Email: fake@neicon.ru
MD, PhD, Professor, Honored Science Worker of the Russian Federation, Head of Department of Cardiovascular Surgery
Russian FederationYu. B. Lishmanov
Research Institute for Сardiology
Email: fake@neicon.ru
MD, PhD, Professor, Correspondent Member of the Russian Academy of Sciences, Head of Department of Radionuclide Investigations
Russian FederationS. V. Popov
Research Institute for Сardiology
Email: fake@neicon.ru
MD, PhD, Professor, Correspondent Member of the Russian Academy of Sciences, Head of Department of Surgical Treatment of Complex Heart Arrythmias and Electrical Cardiac Stimulation
Russian FederationR. S. Karpov
Research Institute for Сardiology
Email: fake@neicon.ru
MD, PhD, Professor, Member of the Russian Academy of Sciences, Director
Russian FederationReferences
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