End-systolic versus end-diastolic late XXXX enhanced imaging for the assessment of scar transmurality.

@entity1 @entity227 @entity296 @entity63 @entity7097 @entity453 @entity2287
Late @entity2287 enhancement (LGE) is widely used to precisely localize and determine the extent and transmurality of @entity296 . Performing LGE imaging at end-systole may reduce motion artefacts. It is therefore important to know whether end-systolic imaging influences infarct transmurality in @entity1 with @entity63 . 107 dysfunctional segments were studied in 20 consecutive @entity1 with established @entity453 . @entity1 specific trigger delays were used to obtain end-diastolic and end-systolic LGE images (LGE(ed), LGE(es)). Wall thickness ( @entity7097 (ed), @entity7097 (es)), thickness of the remaining viable rim (RIM(ed), RIM(es)) and end-diastolic scar thickness were measured manually. There was LGE in 84% of all dysfunctional segments with a mean scar of 3.4    2.5 mm. Total wall thickness and the thickness of the remaining viable rim increased from diastole to systole ( @entity7097 (ed) 7.8    1.9 vs. @entity7097 (es) 8.4    2.2; P < 0.001; RIM(ed) 4.4    3.1 vs. RIM(es) 5    3.4; P < 0.001). Transmurality of scar decreased from end-diastole to end-systole (LGE(ed) 46    33% vs. LGE(es) 44    33%; P < 0.001). This was most pronounced in a subgroup of segments (n = 15) with @entity227 between 50 and 75% (LGE(ed) 75    15% vs. LGE(es) 70    16%; P < 0.001). The change in transmurality was inversely correlated with the change of the thickness of the remaining viable rim between diastole and systole (r = -0.7; P < 0.001). Scar transmurality was reduced by up to 12% in the individual @entity1 . Scar transmurality changes due to thickening of the remaining viable rim. Whereas these differences might not impact on clinical decision-making in most @entity1 , there will be an occasional misclassification if cut-off values are used (e.g. scar <50 or >50%) or if exact data is required for research studies.
