Cardiac Magnetic Resonance to Detect the Underlying Substrate in Patients with Frequent Idiopathic Ventricular Arrhythmias.
Chrysovalantou Nikolaidou, Christos P Kotanidis, Rohan Wijesurendra, Joana Leal-Pelado, Konstantinos Kouskouras, Vassilios P Vassilikos, Haralambos Karvounis, Ntobeko Ntusi, Charalambos Antoniades, Stefan Neubauer, Theodoros D Karamitsos
Author Information
Chrysovalantou Nikolaidou: Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford OX3 9DU, UK.
Christos P Kotanidis: Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford OX3 9DU, UK.
Rohan Wijesurendra: Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford OX3 9DU, UK.
Joana Leal-Pelado: Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford OX3 9DU, UK.
Konstantinos Kouskouras: Department of Radiology, AHEPA Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece.
Vassilios P Vassilikos: Third Department of Cardiology, Hippokration Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 546 43 Thessaloniki, Greece. ORCID
Haralambos Karvounis: First Department of Cardiology, AHEPA Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece.
Ntobeko Ntusi: Department of Medicine, University of Cape Town and Groote Schuur Hospital, 7925 Cape Town, South Africa.
Charalambos Antoniades: Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford OX3 9DU, UK.
Stefan Neubauer: Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford OX3 9DU, UK.
Theodoros D Karamitsos: First Department of Cardiology, AHEPA Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece. ORCID
BACKGROUND: A routine diagnostic work-up does not identify structural abnormalities in a substantial proportion of patients with idiopathic ventricular arrhythmias (VAs). We investigated the added value of cardiac magnetic resonance (CMR) imaging in this group of patients. METHODS: A single-centre prospective study was undertaken of 72 patients (mean age 46 �� 16 years; 53% females) with frequent premature ventricular contractions (PVCs ��� 500/24 h) and/or non-sustained ventricular tachycardia (NSVT), an otherwise normal electrocardiogram, normal echocardiography and no coronary artery disease. RESULTS: CMR provided an additional diagnostic yield in 54.2% of patients. The most prevalent diagnosis was previous myocarditis (23.6%) followed by possible PVC-related cardiomyopathy (20.8%), non-ischaemic cardiomyopathy (8.3%) and ischaemic heart disease (1.4%). The predictors of abnormal CMR findings were male gender, age and PVCs/NSVT non-outflow tract-related or with multiple morphologies. patients with VAs had an impaired peak left ventricular (LV) global radial strain (GRS) compared with the controls (28.88% (IQR: 25.87% to 33.97%) vs. 36.65% (IQR: 33.19% to 40.2%), < 0.001) and a global circumferential strain (GCS) (-17.66% (IQR: -19.62% to -16.23%) vs. -20.66% (IQR: -21.72% to -19.6%), < 0.001). CONCLUSION: CMR reveals abnormalities in a significant proportion of patients with frequent idiopathic VAs. Male gender, age and non-outflow tract PVC origin can be clinical indicators for CMR referral.
