Myocardial fibrosis evaluated by delayed-enhancement magnetic resonance imaging is associated with ventricular tachycardia in patients with cardiomyopathy

Abstract Background: Ventricular tachycardia (VT) is one of the important causes of morbidity and mortality in patients with cardiomyopathy. Recent clinical and experimental studies have demonstrated that myocardial fibrosis is associated with VT. Direct imaging of myocardial fibrosis is now possible with the use of gadolinium-chelate (Gd) enhanced T1-weighted magnetic resonance imaging named delayed-enhancement (DE) MRI. Purpose: The purpose of this study is to investigate the association between VT and myocardial fibrosis in patients with cardiomyopathy. Method: Twenty-one patients with cardiomyopathy (sixteen idiopathic dilated cardiomyopathy and five hypertrophic cardiomyopathy, 13 male, mean age 62.5 years) who had admitted to our hospital were investigated in this study. Patients were evaluated arrhythmia including VT by continuous ECG monitoring at least 5 days. VT was defined as continuous ventricular beats (more than 3 beats) with cycle length less than 500 ms. MRI was performed 15 minutes later after Gd injection, and high grade hyperenhancement was defined positive DE. Result: VT was seen in 8 patients (including 2 sustained VT). Positive DE was identified in 8 patients. There were no differences in clinical characteristics between positive and negative DE patients. Among negative DE (N = 13), VT was seen in 2 (15%), whereas among positive DE (N = 8), seen in 6 (75%) (P = 0.02). Conclusion: Myocardial fibrosis with positive DE is highly associated with VT in patients with cardiomyopathy.