Computed Tomography-Derived Myocardial Wall Thickness and Extracellular Volume Quantification and Correlation for Identifying Ischaemic Scar

Localisation of myocardial fibrosis is an important factor in treatment planning as scar-related ventricular arrhythmias are the main precursor to sudden cardiac death (SCD). Fibrosis may be identified by anatomic properties including a decreased wall thickness (WT), increased extracellular volume (ECV), and lateenhancement cardiac imaging.Cardiac CT data from a cohort of 7 ischaemic ventricular tachycardia (VT) catheter ablation patients were used to construct personalized 3D models.The leftventricular WT (LVWT) was computed between the simply connected boundaries of the LV model's endocardial and epicardial surfaces.The ECV was quantified at the CT image level using a lateenhancement protocol and interpolated to the LV model.The paired measurements of the finite elements allow a thorough delineation of myocardial tissue.Linear regression analysis of LVWT and ECV showed a negative fit for fibrotic ( 2 = 0.57, < 0.001) and healthy myocardial regions ( 2 = 0.98, < 0.001).This preliminary study motivates the investigation of LVWT and ECV as indicators of arrhythmic substrate.