{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:14:01Z","timestamp":1790788441910,"version":"4.1.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,2,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Late gadolinium enhancement (\n              <jats:styled-content style=\"fixed-case\">LGE<\/jats:styled-content>\n              ) is the current standard for myocardial scar delineation. In this study, we introduce the tractographic propagation angle (\n              <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\n              ), a metric of myofiber curvature (degrees\/unit distance) derived from diffusion tensor imaging (\n              <jats:styled-content style=\"fixed-case\">DTI<\/jats:styled-content>\n              ), and compare its use to\n              <jats:styled-content style=\"fixed-case\">LGE<\/jats:styled-content>\n              and invasive scar assessment by endocardial voltage mapping.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">DTI<\/jats:styled-content>\n              was performed on 7 healthy human volunteers, 5 patients with myocardial infarction, 6 normal mice, and 7 mice with myocardial infarction.\n              <jats:styled-content style=\"fixed-case\">LGE<\/jats:styled-content>\n              to delineate the infarct and border zones was performed with a 2\u2010dimensional inversion recovery gradient\u2010echo sequence. Ex vivo\n              <jats:styled-content style=\"fixed-case\">DTI<\/jats:styled-content>\n              was performed on 5 normal human and 5 normal sheep hearts. Endocardial electroanatomic mapping and subsequent ex\u00a0vivo\n              <jats:styled-content style=\"fixed-case\">DTI<\/jats:styled-content>\n              was performed on 5 infarcted sheep hearts.\n              <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\n              in the normal human hearts varied smoothly and was generally &lt;4. The mean\n              <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\n              in the infarct zone was significantly elevated (10.34\u00b11.02 versus 4.05\u00b10.45,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05). Regions with a\n              <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\n              \u22644 consistently had a bipolar voltage \u22651.5\u00a0mV, whereas those with\n              <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\n              values between 4 and 10 had voltages between 0.5 and 1.5\u00a0mV. A\n              <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\n              threshold &gt;4 was the most accurate\n              <jats:styled-content style=\"fixed-case\">DTI<\/jats:styled-content>\n              \u2010derived measure of infarct size and demonstrated the greatest correlation with\n              <jats:styled-content style=\"fixed-case\">LGE<\/jats:styled-content>\n              (\n              <jats:italic>r<\/jats:italic>\n              =0.95).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We found a strong correlation between infarct size by\n              <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\n              and\n              <jats:styled-content style=\"fixed-case\">LGE<\/jats:styled-content>\n              in both mice and humans. There was also an inverse relationship between\n              <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\n              values and endocardial voltage. The use of\n              <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\n              may enable myocardial scar delineation and characterization of arrhythmogenic substrate without the need for exogenous contrast agents.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.007834","type":"journal-article","created":{"date-parts":[[2018,2,8]],"date-time":"2018-02-08T09:44:18Z","timestamp":1518083058000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Myocardial Scar Delineation Using Diffusion Tensor Magnetic Resonance Tractography"],"prefix":"10.1161","volume":"7","author":[{"given":"Choukri","family":"Mekkaoui","sequence":"first","affiliation":[{"name":"Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel P.","family":"Jackowski","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Institute of Mathematics and Statistics, University of S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Kostis","sequence":"additional","affiliation":[{"name":"Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital Harvard Medical School, Boston, MA"},{"name":"Cardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian T.","family":"Stoeck","sequence":"additional","affiliation":[{"name":"Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravinda","family":"Thiagalingam","sequence":"additional","affiliation":[{"name":"Cardiology Department, Westmead Hospital, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy G.","family":"Reese","sequence":"additional","affiliation":[{"name":"Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek Y.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Service, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy N.","family":"Ruskin","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Service, Department of Medicine, Massachusetts General Hospital Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Kozerke","sequence":"additional","affiliation":[{"name":"Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Sosnovik","sequence":"additional","affiliation":[{"name":"Department of Radiology, Athinoula A. 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