[Value of myocardial scar in predicting malignant ventricular arrhythmia in patients with chronic myocardial infarction]

Objective: To assess the predictive value of myocardial scar mass in malignant ventricular arrhythmia (MVA) after myocardial infarction.

Methods: Thirty myocardial infarction patients with complete electrophysiology and cardiac MRI data admitted from January 2012 to August 2017 were enrolled in the study. According to the results of intracavitary electrophysiological study, MVA developed in 16 patients (MVA group) and not developed in 14 patients (non-MVA group). The qualitative and quantitative analysis of left ventricular ejection fraction (LVFE) and scar mass was performed with CV^I42 post-processing software and predictive value of myocardial scar and LVEF for MVA after myocardial infarction was analyzed using ROC curves.

Results: LVEF in MVA group was significantly lower than that in non-MVA group, and scar mass in MVA group was significantly higher than that in non-MVA group (all P<0.05). Regression analysis showed that LVEF (OR=1.580) and scar mass (OR=6.270) were risk factors for MVA after myocardial infarction. For predicting MVA, the area under ROC curve (AUC) of LVEF was 0.696 with a sensitivity of 0.786 and the specificity of 0.685; the AUC of the scar mass was 0.839 with a sensitivity was 0.618 and the specificity of 0.929; the AUC of LVEF combined with scar mass was 0.848 with a sensitivity of 0.688 and specificity of 0.857.

Conclusions: Myocardial scar assessed by late gadolinium enhancement MRI is more effective than LVEF in predicting MVA after myocardial infarction.