Discrimination of sustained VT in structural heart disease using LGE-CMR and computational simulation: moving beyond LVEF - Summary - MDSpire

Discrimination of sustained VT in structural heart disease using LGE-CMR and computational simulation: moving beyond LVEF

  • By

  • Kun Zuo

  • Kuibao Li

  • Lucheng Xu

  • Yiming Wang

  • Shiwei Lu

  • Zhaokai Kong

  • Zhenyin Fu

  • Jianjun Zhang

  • Ruiqing Dong

  • Ling Xia

  • Dongdong Deng

  • Zheng Liu

  • July 7, 2026

  • 0 min

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Objective:

To develop an exploratory model integrating late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) scar characteristics with computational VT simulation to discriminate sustained VT, compared against LVEF.

Approach:
  • Study Design: Single-centre retrospective study enrolling patients with suspected structural heart disease (SHD) who underwent LGE-CMR.
  • Patient Analysis: Patients with LGE-positive underwent quantitative scar analysis, personalized digital heart-twin reconstruction, and virtual electrophysiological simulation.
Key Findings:
  • Among82patients(meanage59.1years;82.9%male),15experiencedsustainedVT.LowerLVEFwasassociatedwithsustainedVT(P=0.008;C-statistic:0.730),aswasvisualLGEpositivity(P=0.023;C-statistic:0.634).AmongLGE-positivepatients,thosewithsustainedVThadalargercorescar[10.0[5.9,14.8]%vs.2.2[1.1,4.7]%;P<0.001],largergreyzone[14.0[10.9,14.7]%vs.5.7[2.3,9.2]%;P<0.001],higherVTinducibility[50.0[22.9,66.9]%vs.0(0,21.1)%;P<0.001],andagreaternumberofinducibleVTcircuits[2[2,4]vs.0[0,2];P<0.001].AnintegratedLGE-VTsimindex,derivedfromthesefourparameters,effectivelydiscriminatedsustainedVT(C-statistic:0.816)andremainedindependentlyassociatedwithsustainedVTafteradjustingforLVEF(OR:1.029;95%CI:1.008–1.051;P=0.007).
Interpretation:

The LGE-VTsim index represents an exploratory parameter in identifying patients at risk of sustained VT in SHD, beyond LVEF.

Limitations:
  • Single-centre study may limit generalizability.
  • Retrospective design may introduce bias.
Conclusion:

The study indicates that integrating quantitative LGE-CMR scar assessment with computational simulation may provide insights into risk stratification for sustained VT in patients with SHD.

Original Source(s)

Discrimination of sustained VT in structural heart disease using LGE-CMR and computational simulation: moving beyond LVEF

  • by Kun Zuo, Kuibao Li, Lucheng Xu, Yiming Wang, Shiwei Lu, Zhaokai Kong, Zhenyin Fu, Jianjun Zhang, Ruiqing Dong, Ling Xia, Dongdong Deng, Zheng Liu

  • July 7, 2026

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