Cardiac Scar Pattern Predicts Risk

MRI - possibly good standard for
screening heart; © Johns Hopkins

Twenty-six patients participated in the study. Participants were men and women, with an average age of 53. None had previous signs of coronary artery disease yet were experiencing other symptoms of heart disease, such as shortness of breath, instant fatigue and the inability to walk up stairs.

As part of a baseline MRI, the researchers used a technique developed at Hopkins to map and gauge the precise amount and distribution of scar tissue in the heart’s muscle wall. The amount of scar tissue was measured as a percentage of the thickness of the muscle wall, which is on average about 1 centimetre. Composed of dense, fibrous tissue, with little to no blood supply, scar tissue was clearly visible on the image, the researchers say. After MRI, each patient underwent a standard electrophysiological assessment with a catheter.

Statistical analysis showed that the five patients who tested positive had the characteristic scar pattern, ranging from 26 percent to 75 percent scar tissue, with MRI. While MRI did not explain why the scar tissue forms, such scar patterns have been previously noted on autopsy studies of patients with heart disease. The researchers believe that previous inflammation, injury or excess stress on the heart wall may lead to this fibrosis and scar formation.

“If further tests confirm that MRI measurements of scar tissue accurately predict the risk of arrhythmia-related sudden death, these could become the gold standard for screening who really needs or does not need a defibrillator,” says the study’s senior author, electrophysiologist Henry Halperin, M.D., a professor of medicine, radiology and biomedical engineering at The Johns Hopkins University School of Medicine and its Heart Institute

MEDICA.de; Source: Johns Hopkins Medical Institutions