Late gadolinium enhancement in early repolarization syndrome

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2025-03-01 DOI:10.1016/j.hrthm.2024.07.116

Hiroshi Morita MD, PhD , Saori Asada MD, PhD , Satoshi Nagase MD, PhD , Akira Ueoka MD, PhD , Takuro Masuda MD , Masakazu Miyamoto MD, PhD , Koji Nakagawa MD, PhD , Nobuhiro Nishii MD, PhD , Shinsuke Yuasa MD, PhD

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引用次数: 0

Abstract

Background

In patients with Brugada syndrome, myocardial fibrosis can be identified through epicardial biopsy or cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE). However, the myocardial alterations in patients with early repolarization syndrome (ERS) remain poorly elucidated.

Objective

The objective of this study was to investigate the presence of myocardial fibrosis in patients with ERS by LGE in CMR.

Methods

We retrospectively evaluated 20 patients with ERS, all of whom exhibited J waves in the contiguous 2 leads. The location of J waves was classified as in the septum (V₁-V₂), anterior (V₃-V₄), lateral (I, aVL, V₅-V₆), inferior (II, III, aVF), or posterior (V₇-V₉) regions. To compare the distribution of LGE on CMR imaging with J waves, sections on short-axis view of the left ventricle (LV) were categorized as located in the septum, anterior, lateral, inferior, and posterior regions.

Results

Overall, 85% of ERS patients displayed LGE, which was more prevalent in the septum and posterior regions, followed by the inferior and lateral regions. The presence or absence of J waves and LGE coincided in 61% of LV areas, whereas discordance between the distributions of J waves and LGE was observed in 38%. LGE was most frequent in the septum (75%), where its reflection in J waves may be less robust. The appearance of LGE was not associated with symptoms, electrical storm, or ventricular fibrillation occurrence during follow-up.

Conclusion

LGE is common in patients with ERS, and the distribution of J waves and LGE coincides in approximately 60% of LV areas.

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早期复极综合征的晚期钆增强

背景：Brugada综合征患者的心肌纤维化可通过心外膜活检或心脏磁共振成像（CMR）的晚期钆增强（LGE）来确定。然而，早期复极综合征（ERS）患者的心肌改变仍未得到充分阐明：利用 CMR 中的 LGE 研究 ERS 患者是否存在心肌纤维化：我们对 20 名 ERS 患者进行了回顾性评估，他们都在连续的两个导联中出现了 J 波。J 波的位置分为室间隔（V1-V2）、前部（V3-V4）、外侧（I、aVL、V5-V6）、下部（II、III、aVF）或后部（V7-V9）。为了比较 LGE 在 CMR 中与 J 波的分布情况，左心室短轴切面被分为位于室间隔、前部、外侧、下部和后部区域：总体而言，85% 的 ERS 患者表现出 LGE，其中室间隔和后部区域更为常见，其次是下部和外侧区域。61%的左心室区域存在或不存在J波和LGE，38%的左心室区域J波和LGE分布不一致。LGE 最常出现在室间隔（75%），其在 J 波中的反射可能较弱。LGE 的出现与随访期间的症状、电风暴或 VF 发生无关：结论：LGE 在 ERS 患者中很常见，约有 60% 的左心室区域的 J 波和 LGE 分布一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.