Limits...
Comparison of NOGA endocardial mapping and cardiac magnetic resonance imaging for determining infarct size and infarct transmurality for intramyocardial injection therapy using experimental data.

Pavo N, Jakab A, Emmert MY, Strebinger G, Wolint P, Zimmermann M, Ankersmit HJ, Hoerstrup SP, Maurer G, Gyöngyösi M - PLoS ONE (2014)

Bottom Line: Polar maps of transmural cMRI and bipolar maps of NOGA showed significant association for determining of the extent of transmural infarction (r = 0.727, p<0.001, overlap ratio of 81.6±11.1%) and non-transmural infarction (r = 0.555, p<0.001, overlap ratio of 70.6±18.5%).By combining unipolar and bipolar voltage maps, NOGA endocardial mapping is useful for accurate delineation of the targeted zone for intramyocardial therapy and is comparable to cMRI-LE.This may be useful in patients with contraindications for cMRI who require targeted intramyocardial regenerative therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Medical University of Vienna, Vienna, Austria.

ABSTRACT

Objectives: We compared the accuracy of NOGA endocardial mapping for delineating transmural and non-transmural infarction to the results of cardiac magnetic resonance imaging (cMRI) with late gadolinium enhancement (LE) for guiding intramyocardial reparative substance delivery using data from experimental myocardial infarction studies.

Methods: Sixty domestic pigs underwent diagnostic NOGA endocardial mapping and cMRI-LE 60 days after induction of closed-chest reperfused myocardial infarction. The infarct size was determined by LE of cMRI and by delineation of the infarct core on the unipolar voltage polar map. The sizes of the transmural and non-transmural infarctions were calculated from the cMRI transmurality map using signal intensity (SI) cut-offs of>75% and>25% and from NOGA bipolar maps using bipolar voltage cut-off values of <0.8 mV and <1.9 mV. Linear regression analysis and Bland-Altman plots were used to determine correlations and systematic differences between the two images. The overlapping ratios of the transmural and non-transmural infarcted areas were calculated.

Results: Infarct size as determined by 2D NOGA unipolar voltage polar mapping correlated with the 3D cMRI-LE findings (r = 0.504, p<0.001) with a mean difference of 2.82% in the left ventricular (LV) surface between the two images. Polar maps of transmural cMRI and bipolar maps of NOGA showed significant association for determining of the extent of transmural infarction (r = 0.727, p<0.001, overlap ratio of 81.6±11.1%) and non-transmural infarction (r = 0.555, p<0.001, overlap ratio of 70.6±18.5%). NOGA overestimated the transmural scar size (6.81% of the LV surface) but slightly underestimated the size of the non-transmural infarction (-3.04% of the LV surface).

Conclusions: By combining unipolar and bipolar voltage maps, NOGA endocardial mapping is useful for accurate delineation of the targeted zone for intramyocardial therapy and is comparable to cMRI-LE. This may be useful in patients with contraindications for cMRI who require targeted intramyocardial regenerative therapy.

Show MeSH

Related in: MedlinePlus

Correlation between NOGA endocardial mapping and cardiac magnetic resonance imaging (cMRI) and statistical analysis of the determination of infarct size.A. Regression equation between the size of the infarct core as determined on a unipolar voltage map (UPV) and as determined using late enhancement cMRI. B. Bland-Altman plot of the size of the infarct core as determined on a unipolar voltage map and the size as determined using late enhancement cMRI. Mean (black line) ±2SD (blue line).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4237404&req=5

pone-0113245-g007: Correlation between NOGA endocardial mapping and cardiac magnetic resonance imaging (cMRI) and statistical analysis of the determination of infarct size.A. Regression equation between the size of the infarct core as determined on a unipolar voltage map (UPV) and as determined using late enhancement cMRI. B. Bland-Altman plot of the size of the infarct core as determined on a unipolar voltage map and the size as determined using late enhancement cMRI. Mean (black line) ±2SD (blue line).

Mentions: There was a significant correlation (r = 0.504, p<0.001) between the infarct size as determined using the NOGA unipolar voltage polar map and the size determined by cMRI-LE. The Bland-Altman plot showed that NOGA mapping resulted in a systematically higher infarct size compared to cMRI-LE, with a mean difference between the two images of 2.82±7.43% in the LV surface (Fig. 7).


Comparison of NOGA endocardial mapping and cardiac magnetic resonance imaging for determining infarct size and infarct transmurality for intramyocardial injection therapy using experimental data.

Pavo N, Jakab A, Emmert MY, Strebinger G, Wolint P, Zimmermann M, Ankersmit HJ, Hoerstrup SP, Maurer G, Gyöngyösi M - PLoS ONE (2014)

Correlation between NOGA endocardial mapping and cardiac magnetic resonance imaging (cMRI) and statistical analysis of the determination of infarct size.A. Regression equation between the size of the infarct core as determined on a unipolar voltage map (UPV) and as determined using late enhancement cMRI. B. Bland-Altman plot of the size of the infarct core as determined on a unipolar voltage map and the size as determined using late enhancement cMRI. Mean (black line) ±2SD (blue line).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4237404&req=5

pone-0113245-g007: Correlation between NOGA endocardial mapping and cardiac magnetic resonance imaging (cMRI) and statistical analysis of the determination of infarct size.A. Regression equation between the size of the infarct core as determined on a unipolar voltage map (UPV) and as determined using late enhancement cMRI. B. Bland-Altman plot of the size of the infarct core as determined on a unipolar voltage map and the size as determined using late enhancement cMRI. Mean (black line) ±2SD (blue line).
Mentions: There was a significant correlation (r = 0.504, p<0.001) between the infarct size as determined using the NOGA unipolar voltage polar map and the size determined by cMRI-LE. The Bland-Altman plot showed that NOGA mapping resulted in a systematically higher infarct size compared to cMRI-LE, with a mean difference between the two images of 2.82±7.43% in the LV surface (Fig. 7).

Bottom Line: Polar maps of transmural cMRI and bipolar maps of NOGA showed significant association for determining of the extent of transmural infarction (r = 0.727, p<0.001, overlap ratio of 81.6±11.1%) and non-transmural infarction (r = 0.555, p<0.001, overlap ratio of 70.6±18.5%).By combining unipolar and bipolar voltage maps, NOGA endocardial mapping is useful for accurate delineation of the targeted zone for intramyocardial therapy and is comparable to cMRI-LE.This may be useful in patients with contraindications for cMRI who require targeted intramyocardial regenerative therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Medical University of Vienna, Vienna, Austria.

ABSTRACT

Objectives: We compared the accuracy of NOGA endocardial mapping for delineating transmural and non-transmural infarction to the results of cardiac magnetic resonance imaging (cMRI) with late gadolinium enhancement (LE) for guiding intramyocardial reparative substance delivery using data from experimental myocardial infarction studies.

Methods: Sixty domestic pigs underwent diagnostic NOGA endocardial mapping and cMRI-LE 60 days after induction of closed-chest reperfused myocardial infarction. The infarct size was determined by LE of cMRI and by delineation of the infarct core on the unipolar voltage polar map. The sizes of the transmural and non-transmural infarctions were calculated from the cMRI transmurality map using signal intensity (SI) cut-offs of>75% and>25% and from NOGA bipolar maps using bipolar voltage cut-off values of <0.8 mV and <1.9 mV. Linear regression analysis and Bland-Altman plots were used to determine correlations and systematic differences between the two images. The overlapping ratios of the transmural and non-transmural infarcted areas were calculated.

Results: Infarct size as determined by 2D NOGA unipolar voltage polar mapping correlated with the 3D cMRI-LE findings (r = 0.504, p<0.001) with a mean difference of 2.82% in the left ventricular (LV) surface between the two images. Polar maps of transmural cMRI and bipolar maps of NOGA showed significant association for determining of the extent of transmural infarction (r = 0.727, p<0.001, overlap ratio of 81.6±11.1%) and non-transmural infarction (r = 0.555, p<0.001, overlap ratio of 70.6±18.5%). NOGA overestimated the transmural scar size (6.81% of the LV surface) but slightly underestimated the size of the non-transmural infarction (-3.04% of the LV surface).

Conclusions: By combining unipolar and bipolar voltage maps, NOGA endocardial mapping is useful for accurate delineation of the targeted zone for intramyocardial therapy and is comparable to cMRI-LE. This may be useful in patients with contraindications for cMRI who require targeted intramyocardial regenerative therapy.

Show MeSH
Related in: MedlinePlus