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Detecting Regional Myocardial Abnormalities in Patients With Wolff-Parkinson-White Syndrome With the Use of ECG-Gated Cardiac MDCT.

Authors
 Hye-Jeong Lee  ;  Jae-Sun Uhm  ;  Boyoung Joung  ;  Yoo Jin Hong  ;  Jin Hur  ;  Byoung Wook Choi  ;  Young Jin Kim 
Citation
 American Journal of Roentgenology, Vol.206(4) : 719-725, 2016 
Journal Title
 American Journal of Roentgenology 
ISSN
 0361-803X 
Issue Date
2016
MeSH
Adult ; Cardiac-Gated Imaging Techniques/methods* ; Case-Control Studies ; Contrast Media ; Echocardiography ; Electrophysiologic Techniques, Cardiac ; Female ; Humans ; Iopamidol ; Male ; Middle Aged ; Multidetector Computed Tomography/methods* ; Retrospective Studies ; Wolff-Parkinson-White Syndrome/diagnostic imaging*
Keywords
Wolff-Parkinson-White syndrome ; cardiac CT ; myocardial hypotrophy ; segmental dyskinesia ; ventricular preexcitation
Abstract
OBJECTIVE: Myocardial dyskinesia caused by the accessory pathway and related reversible heart failure have been well documented in echocardiographic studies of pediatric patients with Wolff-Parkinson-White (WPW) syndrome. However, the long-term effects of dyskinesia on the myocardium of adult patients have not been studied in depth. The goal of the present study was to evaluate regional myocardial abnormalities on cardiac CT examinations of adult patients with WPW syndrome. MATERIALS AND METHODS: Of 74 patients with WPW syndrome who underwent cardiac CT from January 2006 through December 2013, 58 patients (mean [± SD] age, 52.2 ± 12.7 years), 36 (62.1%) of whom were men, were included in the study after the presence of combined cardiac disease was excluded. Two observers blindly evaluated myocardial thickness and attenuation on cardiac CT scans. On the basis of CT findings, patients were classified as having either normal or abnormal findings. We compared the two groups for other clinical findings, including observations from ECG, echocardiography, and electrophysiologic study. RESULTS: Of the 58 patients studied, 16 patients (27.6%) were found to have myocardial abnormalities (i.e., abnormal wall thinning with or without low attenuation). All abnormal findings corresponded with the location of the accessory pathway. Patients with abnormal findings had statistically significantly decreased left ventricular function, compared with patients with normal findings (p < 0.001). The frequency of regional wall motion abnormality was statistically significantly higher in patients with abnormal findings (p = 0.043). However, echocardiography documented structurally normal hearts in all patients. CONCLUSION: A relatively high frequency (27.6%) of regional myocardial abnormalities was observed on the cardiac CT examinations of adult patients with WPW syndrome. These abnormal findings might reflect the long-term effects of dyskinesia, suggesting irreversible myocardial injury that ultimately causes left ventricular dysfunction.
Full Text
http://www.ajronline.org/doi/abs/10.2214/AJR.15.15141
DOI
10.2214/AJR.15.15141
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김영진(Kim, Young Jin) ORCID logo https://orcid.org/0000-0002-6235-6550
엄재선(Uhm, Jae Sun) ORCID logo https://orcid.org/0000-0002-1611-8172
이혜정(Lee, Hye Jeong) ORCID logo https://orcid.org/0000-0003-4349-9174
정보영(Joung, Bo Young) ORCID logo https://orcid.org/0000-0001-9036-7225
최병욱(Choi, Byoung Wook) ORCID logo https://orcid.org/0000-0002-8873-5444
허진(Hur, Jin) ORCID logo https://orcid.org/0000-0002-8651-6571
홍유진(Hong, Yoo Jin) ORCID logo https://orcid.org/0000-0002-7276-0944
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146801
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