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

Figures

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  Figure 1. Pie chart showing the main categories of CMR diagnoses within the patient population. Most of the patients had normal CMR findings; myocarditis was the second most common diagnosis while a significant proportion of patients were characterised as having possible PVC-related cardiomyopathy. A small proportion of patients were diagnosed with non-ischaemic cardiomyopathy while only one patient had a myocardial infarction. CM: cardiomyopathy; MI: myocardial infarction; PVC: premature ventricular contractions.

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  Figure 2. Feature-tracking CMR 2D left ventricular coloured strain analysis on short-axis (A) and long-axes (B,C) SSFP images. Normal peak radial strain 16-segment map (D) and strain curve (E) from a patient with normal CMR findings and no enhancement on late gadolinium imaging (F); impaired peak radial strain 16-segment map (G) and strain curve (H) in a patient with an enhancement pattern on late gadolinium imaging in keeping with previous myocarditis (I).

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  Figure 3. (A) Box plots showing the median values of the peak left ventricular global radial strain (LV GRS) and the peak left ventricular global circumferential strain (LV GCS) in control subjects and patients with ventricular arrhythmia. (B) Receiver operating characteristic (ROC) curve for the peak left LV GRS; the curve shows a good ability of the peak LV GRS to differentiate the patients from the control subjects. AUC: area under the curve.

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  Figure 4. Box plots showing the median values of the peak left ventricular global circumferential strain (LV GCS) (A) and the peak left ventricular global radial strain (LV GRS) (B) in the different patient groups. Patients with non-ischaemic cardiomyopathy had a significantly impaired peak LV GCS and peak LV GRS compared with patients with previous myocarditis. The peak LV GRS can also differentiate between patients with previous myocarditis and those with premature ventricular contraction (PVC)-related cardiomyopathy. The asterisk indicates p < 0.05.

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  Figure 5. Graphical representation of the study protocol and the main findings.