Abstract 1920: Findings by Magnetic Resonance Imaging in Patients Evaluated for Arrhythmogenic Right Ventricular Cardiomyopathy
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a challenging diagnosis. cMRI has emerged a powerful non invasive technique for the evaluation of patients with suspected ARVC. We hypothesized that in a population referred for the evaluation of ARVC, usually as the result of ventricular tachyarrhythmias, dilation of the right ventricle, or syncope, cMRI may detect other unsuspected abnormalities that may be related to the original complaint.
Methods: Findings in all cMRI studies performed for the evaluation of ARVC were analyzed.
Results: Over a 5 year period 162 studies were performed. There were 83 (51%) normal studies, 45 (28%) with left or biventricular abnormities (delayed contrast enhancement 7%, left ventricular dilation 7%, ventricular dysfunction 11%, other 3%), and 34 patients (21%) with isolated right ventricular abnormalities. cMR examination added 1 minor ARVC task force criteria to 16 patients (10%), 2 minor criteria to 10 patients (6%), 1 major criteria to 6 patients(4%), and 1 major and 1 minor criteria to 6 (4%). The most common RV abnormality was RV dilation (18%), followed by depressed RV ejection fraction (17%), focal RV wall motion abnormalities (10%), and fibrofatty infiltration of the RV (0.5%)
Conclusion: In patients referred with suspected ARVC, just over half had normal cMR studies. In the majority of abnormal studies, left ventricular or biventricular abnormalities are seen. Therefore in patients referred for evaluation of ARVC special care should be taken to include a comprehensive evaluation for other cardiac abnormalities, not just those expected in ARVC.