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Altered myocardial characteristics of the preexcited segment in Wolff-Parkinson-White syndrome: A pilot study with cardiac magnetic resonance imaging

Authors
 Hye-Jeong Lee  ;  Jae-Sun Uhm  ;  Yoo Jin Hong  ;  Jin Hur  ;  Byoung Wook Choi  ;  Boyoung Joung  ;  Young Jin Kim 
Citation
 PLoS One, Vol.13(6) : e0198218, 2018 
Journal Title
 PLoS One 
Issue Date
2018
Abstract
PURPOSE: The preexcited myocardium of Wolff-Parkinson-White (WPW) syndrome would have different characteristics from normal myocardium and these findings might be related to persistent left ventricular systolic dysfunction. We evaluated myocardial tissue characteristics at the preexcited segment in adult WPW syndrome patients and their implicated findings. METHODS: For this prospective study, we enrolled 22 adult WPW syndrome patients (16 male, mean 45.4 +/- 17.8 years) with echocardiographic findings of regional wall motion abnormality in our electrophysiology clinic. Of these patients, 14 underwent radiofrequency ablation before cardiac magnetic resonance imaging. All patients underwent cardiac magnetic resonance imaging including cine and late gadolinium enhancement. The ventricular morphology, function and myocardial characteristics of the preexcited segment were analyzed. RESULTS: A relatively high prevalence of late gadolinium enhancement (9/22, 40.9%) was observed exclusively at the basal septum. The septal accessory pathway was significantly more prevalent in patients with late gadolinium enhancement (P = 0.011). The prevalences of regional myocardial wall thinning and regional akinesia were significantly higher (P = 0.001 for both) and left ventricular function was significantly decreased in patients with late gadolinium enhancement (P < 0.001). In addition, there were no significant relationships between radiofrequency ablation and regional akinesia (P > 0.999), regional myocardial wall thinning (P > 0.999), late gadolinium enhancement (P = 0.662) and low ejection fraction (P > 0.999). CONCLUSION: Myocardial fibrosis was observed at the preexcited myocardium of adult WPW syndrome patients with septal accessory pathway, which could accompany regional akinesia and regional myocardial wall thinning and might be related to persistent left ventricular systolic dysfunction even after radiofrequency ablation.
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DOI
10.1371/journal.pone.0198218
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
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162484
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