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New evaluation features of ventricular arrhythmia substrate: therole of magnetic resonance imaging

Authors: Berdibekov B.Sh., Aleksandrova S.A., Golukhova E.Z.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2019-13-3-217-228

For citation: Berdibekov B.Sh., Aleksandrova S.A., Golukhova E.Z. New evaluation features of ventricular arrhythmia substrate: the role of magnetic resonance imaging. Creative Cardiology. 2019; 13 (3): 217–28 (in Russ.). DOI: 10.24022/ 1997-3187-2019-13-3-217-228

Received / Accepted:  15.08.2019/27.08.2019

Keywords: magnetic resonance imaging ventricular arrhythmias myocardial fibrosis

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Abstract

Myocardial fibrosis is a major pathophysiologic determinant of the appearence and maintenance of recurrent ventricular arrhythmias which are usually associated with structural heart disease. However, the arrhythmogenic substrate and its cause may remain unclear in about 50% of cases after traditional diagnostic evaluation, including a 12-channel electrocardiography, transthoracic echocardiography and coronary angiography/computed tomography. In the past decade, magnetic resonance imaging of the heart has acquired an increasing role as a reliable diagnostic tool, and is the reference method for non-invasive detection and evaluation of myocardial fibrosis confirmed by validated data, including histological studies. Sudden cardiac death prevention strategies are hampered by overreliance on left ventricular ejection fraction below 35%. But this approach further fails to identify individuals who experience the majority, as many as 80%, of sudden cardiac death events which occur in the setting of more preserved left ventricular ejection fraction. Fibrosis detection and measurement with late gadolinium enhancement has been closely associated with arrhythmogenic events in numerous studies. The article presents an overview of recent data on the role of magnetic resonance imaging in the prediction of arrhythmic events in patients with coronary and/or non-coronary myocardial diseases.

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About Authors

  • Bektur Sh. Berdibekov, Postgraduate, ORCID;
  • Svetlana A. Aleksandrova, Cand. Med. Sc., Senior Researcher, ORCID;
  • Elena Z. Golukhova, Dr Med. Sc., Professor, Academician of RAS, Head of Department, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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