Correlation of morphological and hemodynamic cardiovascular magnetic resonance criteria in patients with arrhythmogenic right ventricular cardiomyopathy
- Genova, T. Shalganov, E. Tasheva, R. Petkov
The purpose of this study was to determine correlation between hemodynamic and morphological features with cardiovascular magnetic resonance (CMR) in patients with ARVC. Revised Task force criteria (TFC) do not include morphological CMR features for diagnosis of ARVC to avoid false positive results. Nevertheless, CMR gives most comprehensive evaluation of both hemodynamic and morphological abnormalities in this disease. Recent technological advances in CMR imaging have resulted in images with high spatial and temporal resolution and excellent myocardial tissue characterization. Two experienced observers independently evaluated CMR data from 48 examinations with clinically suspected ARVC. The MRI scan was performed according to a standard MRI protocol on a 1.5-T scanner. The observers reported on fatty infiltration, thinned myocardium, late gadolinium enhancement (LGE), global and regional RV function. A morphological abnormality was considered existing when both observers reported it. RV volumes and ejection fraction (EF) were calculated on the short axis cine sequences. Thirty patients met revised TFC for ARVC. We found a good correlation between hemodynamic (reduced EF, enlarged RV volumes) and morphological features- fatty infiltration and LGE. Fatty myocardial deposits and LGE areas were found in 56.7% and 96.2% of the patients. In all subjects the fatty myocardial deposits and LGE were detected in the regions with motion abnormalities and thinned myocardium. Our results show that, when reported by experienced observers, morphological abnormalities correlate well with TFC established CMR criteria for ARVC. CMR is a valuable imaging technique for detection and assessment of the morphology and the functional characteristics of patients with ADVC.
Key words: ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY. CARDIOVASCULAR MAGNETIC RESONANCE. MORPHOLOGICAL ABNORMALITY. CORRELATION OF CRITERIA