Utility of Myocardial Fibrosis and Fatty Infiltration Detected by Cardiac Magnetic Resonance Imaging in the Diagnosis of Arrhythmogenic Right Ventricular Dysplasia—A Single Centre Experience

Introduction Cardiac magnetic resonance imaging (CMR) has evolved as a major diagnostic tool to evaluate arrhythmogenic right ventricular dysplasia (ARVD). However, there is a lack of consensus in the interpretation of findings such as fatty infiltration or myocardial fibrosis. We examined the diagn...

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Bibliographic Details
Published in:Heart, lung & circulation lung & circulation, 2008-12, Vol.17 (6), p.478-483
Main Authors: Pfluger, Heinz B., MD, Phrommintikul, Arintaya, MD, Mariani, Justin A., FRACP, Cherayath, Joshi G., Dip. AMIT, Taylor, Andrew J., PhD
Format: Article
Language:English
Subjects:
Adult
Arrhythmogenic Right Ventricular Dysplasia - diagnosis
Arrhythmogenic Right Ventricular Dysplasia - pathology
ARVD
Cardiac magnetic resonance imaging
Cardiovascular
Cohort Studies
Delayed enhancement
Fatty infiltration
Female
Humans
Magnetic Resonance Imaging, Cine
Male
Middle Aged
Sensitivity and Specificity
Young Adult
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Summary:Introduction Cardiac magnetic resonance imaging (CMR) has evolved as a major diagnostic tool to evaluate arrhythmogenic right ventricular dysplasia (ARVD). However, there is a lack of consensus in the interpretation of findings such as fatty infiltration or myocardial fibrosis. We examined the diagnostic utility of these two features in the diagnosis of ARVD. Methods We performed fast imaging employing steady-state acquisition cine imaging, T1 -weighted black blood imaging with and without fat suppression and post-contrast delayed enhancement on a 1.5-T scanner to evaluate ventricular function and morphology, fatty infiltration and regional myocardial fibrosis in 52 subjects with suspected ARVD. Results Eight subjects met the international diagnostic criteria for ARVD. Right ventricle (RV) delayed hyper-enhancement was found in 7 of 8 (88%) ARVD subjects compared to 6 of 44 (14%) subjects without ARVD ( p < 0.001). Fatty infiltration was only identified in 1 ARVD patient, and 1 non-ARVD patient. On multiple logistic regression analysis RV enhancement remained an independent predictor for the diagnosis of ARVD ( p < 0.05). Conclusion RV delayed enhancement is common in patients with ARVD, whereas detection of fatty infiltration of the right ventricle was rare in our patient population. The inclusion of RV fibrosis on CMR as a feature of ARVD may improve the diagnostic accuracy of this condition.
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2008.03.085