Evaluation of a T1 mapping technique for stratifying patient risk: A preliminary study using computer simulations of cardiac electrophysiology

Heterogeneous scarred tissue, or infarct, stemming from coronary artery occlusion has been linked to ventricular tachycardia (VT). Myocardial infarct (MI)-based indices derived from contrast enhanced (CE) magnetic resonance have been increasingly investigated to complement the standard risk stratification strategy of patients for implantable cardioverter defibrillator (ICD) therapy. Compared to conventional CE-MRI, measurements derived using Multi-Contrast Late Enhancement (MCLE), a novel T1 mapping technique, have been shown to be more sensitive in predicting appropriate ICD therapy for patients post-MI The objective of this study is to evaluate MCLE for stratifying patient risk using computer simulations of cardiac electrophysiology. A cohort of 25 patients with ischemic cardiomyopathy were imaged using both techniques prior to ICD implantation and were followed up for 6-46 months. Acquired images from both techniques were semi-automatically segmented to create computational models of the heart. These models were then virtually stimulated. The study concluded that MCLE is slightly more reproducible than the conventional CE-MRI. and preliminary results indicated that MCLE showed higher sensitivity and specificity than its counterpart in predicting appropriate ICD therapy.