Details

Autor(en) / Beteiligte

• Basile, Paolo
• Soldato, Nicolò
• Pedio, Erika
• Siena, Paola
• Carella, Maria Cristina
• Dentamaro, Ilaria
• Khan, Yamna
• Baggiano, Andrea
• Mushtaq, Saima
• Forleo, Cinzia
• Ciccone, Marco Matteo
• Pontone, Gianluca
• Guaricci, Andrea Igoren

Titel

Cardiac magnetic resonance reveals concealed structural heart disease in patients with frequent premature ventricular contractions and normal echocardiography: A systematic review

Ist Teil von

• International journal of cardiology, 2024-10, Vol.412, p.132306, Article 132306

Ort / Verlag

Elsevier B.V

Erscheinungsjahr

2024

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Premature ventricular contractions (PVCs) are a common form of arrhythmic events, often representing an idiopathic and benign condition without further therapeutic interventions. However, in certain circumstances PVCs may represent the epiphenomenon of a concealed structural heart disease (SHD). Surface 12‑leads EKG and 24-h dynamic EKG are necessary to assess their main characteristics such as site of origin, frequency and complexity. Echocardiography represents the first-line imaging tool recommended to evaluate cardiac structures and function. Cardiac Magnetic Resonance (CMR) is recognized as a superior modality for detecting structural cardiac alterations, that might evade detection by conventional echocardiography. Moreover, in specific populations such as athletes, CMR may have a crucial role to exclude a concealed SHD and the risk of serious arrhythmic events during sport activity. Some clinical characteristics such as male sex, older age or family history of sudden cardiac death (SCD) or cardiomyopathy, and some electrocardiographic features of PVCs, in particular a right branch bundle block (RBBB) with superior/intermediate axis morphology, the reproducibility of VAs during exercise test (ET) or the evidence of complex ventricular arrhythmias, may warrant a CMR evaluation, due to the high probability of SHD. In this systematic review our objective was to provide an exhaustive overview on the role of CMR in detecting a concealed SHD in patients with high daily burden of PVCs and a normal echocardiographic evaluation, paving the way for a more extensive utilization of CMR in presence of certain high-risk clinical and/or EKG features identified during the diagnostic workup. •Cardiac Magnetic Resonance (CMR) is the better modality for detecting structural heart disease (SHD).•The prevalence of SHD at CMR is non negligible, ranging from 11 to 84% across studies.•Some clinical and EKG features may suggest a CMR due to the higher probability of SHD.•Male sex, older age, family history of SCD/cardiomyopathy are high risk clinical features.•RBBB with superior/intermediate axis, reproducibility during exercise test or complex VAs are high risk EKG characteristics.