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

Hye Jeong Lee, Jae Sun Uhm, Yoo Jin Hong, Jin Hur, Byoung Wook Choi, Boyoung Joung, Young Jin Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 (PÆ 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.

Original languageEnglish
Article numbere0198218
JournalPloS one
Volume13
Issue number6
DOIs
Publication statusPublished - 2018 Jun

Fingerprint

Wolff-Parkinson-White Syndrome
Gadolinium
Magnetic resonance
gadolinium
magnetic resonance imaging
Magnetic Resonance Imaging
Imaging techniques
myocardium
Accessories
Ablation
Myocardium
Left Ventricular Dysfunction
Electrophysiology
Cine Magnetic Resonance Imaging
electrophysiology
Ventricular Function
prospective studies
fibrosis
Left Ventricular Function
Tissue

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

@article{00363cb4710043f195ddbea3b48e0408,
title = "Altered myocardial characteristics of the preexcited segment in Wolff-Parkinson-White syndrome: A pilot study with cardiac magnetic resonance imaging",
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{\AE} 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.",
author = "Lee, {Hye Jeong} and Uhm, {Jae Sun} and Hong, {Yoo Jin} and Jin Hur and Choi, {Byoung Wook} and Boyoung Joung and Kim, {Young Jin}",
year = "2018",
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Altered myocardial characteristics of the preexcited segment in Wolff-Parkinson-White syndrome : A pilot study with cardiac magnetic resonance imaging. / Lee, Hye Jeong; Uhm, Jae Sun; Hong, Yoo Jin; Hur, Jin; Choi, Byoung Wook; Joung, Boyoung; Kim, Young Jin.

In: PloS one, Vol. 13, No. 6, e0198218, 06.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Altered myocardial characteristics of the preexcited segment in Wolff-Parkinson-White syndrome

T2 - A pilot study with cardiac magnetic resonance imaging

AU - Lee, Hye Jeong

AU - Uhm, Jae Sun

AU - Hong, Yoo Jin

AU - Hur, Jin

AU - Choi, Byoung Wook

AU - Joung, Boyoung

AU - Kim, Young Jin

PY - 2018/6

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N2 - 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 (PÆ 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.

AB - 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 (PÆ 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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