{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T16:51:03Z","timestamp":1771692663299,"version":"3.50.1"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Brugada syndrome (BrS) is considered a purely electrical disease with variable electrical substrates. Variable rates of mechanical abnormalities have been also reported. Whether exists a link between electrical and mechanical abnormalities has never been previously explored. This investigational physiopathological study aimed to determine the relationship between the substrate size\/location, as exposed by ajmaline provocation, and the severity of mechanical abnormalities, as assessed by cardiac magnetic resonance in patients with BrS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Twenty-four consecutive high-risk patients with BrS (mean age, 38\u00b111 years, 17 males), presenting with malignant syncope and documented polymorphic ventricular tachycardia\/ventricular fibrillation, and candidate to implantable cardioverter defibrillator implantation, underwent cardiac magnetic resonance and electroanatomic maps. During each examination, ajmaline test (1 mg\/kg over 5 minutes) was performed. Cardiac magnetic resonance findings were compared with 24 age, sex, and body surface area-matched controls. In patients with BrS, the correlation between the electrical substrate extent and right ventricular regional mechanical abnormalities before\/after ajmaline challenge was analyzed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              After ajmaline, patients with BrS showed a reduction of right ventricular (RV) ejection fraction (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), associated with decreased transversal displacement (U,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and longitudinal strain (\u03b5,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) localized at RV outflow tract. In patients with BrS significant preajmaline\/postajmaline changes of transversal displacement (\u0394U,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and longitudinal strain (\u0394\u03b5,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) were found. In the control group, no mechanical changes were observed after ajmaline. The electrical substrate consistently increased after ajmaline from 1.7\u00b12.8 cm\n              <jats:sup>2<\/jats:sup>\n              to 14.2\u00b17.3 cm\n              <jats:sup>2<\/jats:sup>\n              (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), extending from the RV outflow tract to the neighboring segments of the RV anterior wall. Postajmaline RV ejection fraction inversely correlated with postajmaline substrate extent (\n              <jats:italic>r<\/jats:italic>\n              =\u22120.830,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). In patients with BrS and normal controls, cardiac magnetic resonance detected neither myocardial fibrosis nor RV outflow tract morphological abnormalities.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>BrS is a dynamic RV electromechanical disease, where functional abnormalities correlate with the maximal extent of the substrate size. These findings open new lights on the physiopathology of the disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrial.gov\">https:\/\/clinicaltrial.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03524079.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.121.010004","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T09:00:11Z","timestamp":1635152411000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Brugada Syndrome: New Insights From Cardiac Magnetic Resonance and Electroanatomical 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