Research Article: Cardiac magnetic resonance imaging in patients referred for premature ventricular contractions: identifying patients most likely to benefit
Abstract:
The value of cardiac magnetic resonance (CMR) imaging in cases of premature ventricular contractions (PVCs) has not been clearly defined.
To assess the ability of CMR to detect structural abnormalities in patients referred for PVCs and to determine predictive factors.
200 consecutive patients were retrospectively included after a workup that included an electrocardiogram, echocardiography, and an exercise test. We determined whether or not CMR could reveal previously undetected structural abnormalities.
CMR revealed structural abnormalities in 92 patients (46% of cases): nonischemic fibrosis ( n =?53, 26.5%), ischemic fibrosis ( n =?18, 9%), mixed fibrosis ( n =?4, 2%), and 4 (2%) cardiomyopathies. In a multivariate analysis, the main predictors of structural abnormalities were age [odds ratio (OR): 1.03; p =?0.016], male sex (OR: 2.48; p =?0.019), diabetes (OR: 5.02; p =?0.010), smoking (OR: 2.09; p =?0.047), known cardiomyopathy (OR: 3.24; p =?0.006), pleomorphic PVCs (OR: 2.48; p =?0.051), and the absence of a decrease in PVC frequency during exercise (OR: 0.24; p <?0.001). In contrast, all young, nondiabetic subjects with unknown cardiomyopathy, normal echocardiography, and monomorphic PVC that decreased in frequency with effort had normal CMR findings.
CMR is essential in the investigation of PVCs; it enabled the detection of structural abnormalities not found during the initial workup in 46% of the cases. Predictive factors included male sex, age, diabetes, smoking, known cardiomyopathy, and pleomorphic PVCs. In contrast, young and nondiabetic patients with normal echocardiography and monomorphic PVCs that decrease in frequency with effort had normal CMR findings; raising the hypothesis that the usefulness of CMR in this specific population should be discussed.
Introduction:
The value of cardiac magnetic resonance (CMR) imaging in cases of premature ventricular contractions (PVCs) has not been clearly defined.
Read more