Nobusada Funabashi MD, PhD, Presenter: Nothing to Disclose

Masae Uehara MD, Abstract Co-Author: Nothing to Disclose

Marehiko Ueda MD, Abstract Co-Author: Nothing to Disclose

Kohki Nakamura MD, Abstract Co-Author: Nothing to Disclose

Hiroyuki Takaoka MD, Abstract Co-Author: Nothing to Disclose

Akihisa Kataoka MD, Abstract Co-Author: Nothing to Disclose

Issei Komuro MD, Abstract Co-Author: Nothing to Disclose

Noriyuki Yanagawa MD, Abstract Co-Author: Nothing to Disclose

To evaluate the characteristics of specific heart images in survivors of ventricular fibrillation (VF) by 320-slice CT.

27 consecutive de novo survivors of VF (21 males, 63±26 yrs), referred to our institute who all had implantable cardioverter defibrillators underwent enhanced retrospective ECG-gated conventional 320-slice CT scan (Aquilion one, Toshiba medical) with 0.5mm slice thickness. Images were reconstructed every 5% from 0-95% of the R-R interval and 4-dimensional images were also reconstructed for evaluation of cardiac motion. If there were contrast defects in the left ventricular (LV) myocardium (LVM) in the early phase, late phase acquisition was added to evaluate abnormal late enhancement (LE), suggesting presence of fibrosis or inflammation.

17 subjects (63%) revealed normal coronary arteries and no organized heart diseases. Two (7%) had abnormal coronary arteries: 1 had giant right coronary arterial aneurysm due to coronary LV fistula, and 1 had Standford A-type aortic dissection with coronary arteries from the true lumen compressed by the false lumen, causing lack of blood flow and finally, acute myocardial infarction. The remaining 8 (30%) had normal coronary arteries but revealed focal abnormalities in the LVM: 3 subjects had essential focal fibro and/or fatty change in the LVM, 2 had focal LVM thinning and fibrosis with reduced LV motion in the lateral wall of the LV, 1 had arrhythmogenic right ventricular cardiomyopathy with LVM invasion, 1 had normal thickened LVM with abnormal LE, suggesting inflammation finally diagnosed as acute myocarditis, and 1 had Moron 2 type hypertrophic cardiomyopathy in whom focal fibrosis in the interventricular septum and inferior wall of the LV.

Organized heart diseases (37% in this study) might frequently exist in survivors of VF. Macro LVM abnormalities may be especially more common than coronary arterial abnormalities in those subjects as shown by 320-slice CT. To detect fibrosis or inflammation, late phase acquisition may be necessary if there are contrast defects in the LVM in the early phase in enhanced CT.

Essential macro LVM abnormalities, not ordinarily observed in normal subjects, may frequently exist in survivors of VF, and this may be useful to predict subjects in whom VF might tend to occur.

Funabashi, N, Uehara, M, Ueda, M, Nakamura, K, Takaoka, H, Kataoka, A, Komuro, I, Yanagawa, N, Characteristics of Specific Heart Imaging in Survivors of Ventricular Fibrillation by 320 Slice CT.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9013906.html