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Article

Cardiac Magnetic Resonance to Detect the Underlying Substrate in Patients with Frequent Idiopathic Ventricular Arrhythmias

1
Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford OX3 9DU, UK
2
First Department of Cardiology, AHEPA Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
3
Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford OX3 9DU, UK
4
Department of Radiology, AHEPA Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
5
Third Department of Cardiology, Hippokration Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 546 43 Thessaloniki, Greece
6
Department of Medicine, University of Cape Town and Groote Schuur Hospital, 7925 Cape Town, South Africa
*
Author to whom correspondence should be addressed.
Academic Editor: Felix G. Meinel
Diagnostics 2021, 11(6), 1109; https://doi.org/10.3390/diagnostics11061109
Received: 1 June 2021 / Revised: 15 June 2021 / Accepted: 15 June 2021 / Published: 18 June 2021
(This article belongs to the Special Issue Advances in Cardiovascular Imaging 2021)
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%), p < 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%), p < 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. View Full-Text
Keywords: cardiac magnetic resonance; premature ventricular contractions; ventricular arrhythmia; myocardial strain; feature-tracking CMR cardiac magnetic resonance; premature ventricular contractions; ventricular arrhythmia; myocardial strain; feature-tracking CMR
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MDPI and ACS Style

Nikolaidou, C.; Kotanidis, C.P.; Wijesurendra, R.; Leal-Pelado, J.; Kouskouras, K.; Vassilikos, V.P.; Karvounis, H.; Ntusi, N.; Antoniades, C.; Neubauer, S.; Karamitsos, T.D. Cardiac Magnetic Resonance to Detect the Underlying Substrate in Patients with Frequent Idiopathic Ventricular Arrhythmias. Diagnostics 2021, 11, 1109. https://doi.org/10.3390/diagnostics11061109

AMA Style

Nikolaidou C, Kotanidis CP, Wijesurendra R, Leal-Pelado J, Kouskouras K, Vassilikos VP, Karvounis H, Ntusi N, Antoniades C, Neubauer S, Karamitsos TD. Cardiac Magnetic Resonance to Detect the Underlying Substrate in Patients with Frequent Idiopathic Ventricular Arrhythmias. Diagnostics. 2021; 11(6):1109. https://doi.org/10.3390/diagnostics11061109

Chicago/Turabian Style

Nikolaidou, Chrysovalantou, Christos P. Kotanidis, Rohan Wijesurendra, Joana Leal-Pelado, Konstantinos Kouskouras, Vassilios P. Vassilikos, Haralambos Karvounis, Ntobeko Ntusi, Charalambos Antoniades, Stefan Neubauer, and Theodoros D. Karamitsos. 2021. "Cardiac Magnetic Resonance to Detect the Underlying Substrate in Patients with Frequent Idiopathic Ventricular Arrhythmias" Diagnostics 11, no. 6: 1109. https://doi.org/10.3390/diagnostics11061109

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