Noninvasive detection of myocardial fibrosis in arrhythmogenic right ventricular cardiomyopathy using delayed-enhancement magnetic resonance imaging

Harikrishna Tandri, Manoj Saranathan, E. Rene Rodriguez, Claudia Martinez, Chandra Bomma, Khurram Nasir, Boas Rosen, João A C Lima, Hugh Calkins, David A. Bluemke

Research output: Contribution to journalArticle

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Abstract

We evaluated the role of myocardial delayed-enhancement (MDE) magnetic resonance imaging (MRI) for noninvasive detection of fibrosis in Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Arrhythmogenic right ventricular dysplasia/cardiomyopathy is characterized by fibro-fatty replacement of the right ventricle (RV) leading to arrhythmias and RV failure. Endomyocardial biopsy can demonstrate fibro-fatty replacement of the RV myocardium; however, the test is invasive and carries a risk of perforation. Thirty consecutive patients were prospectively evaluated for ARVD/C. Magnetic resonance imaging was performed on a 1.5-T scanner. Ten minutes after intravenous administration of 0.2 mmol/kg of gadodiamide, MDE-MRI was obtained. Diagnosis of ARVD/C was based upon the Task Force criteria and did not include MRI findings. Twelve (40%) of 30 patients met the Task Force criteria for ARVD/C. Eight (67%) of the 12 ARVD/C patients demonstrated increased signal on MDE-MRI in the RV compared with none (0%) of the 18 patients without ARVD/C (p < 0.001). Endomyocardial biopsy was performed in 9 of the 12 ARVD/C patients. Of the nine patients, four had fibro-fatty changes consistent with the diagnosis of ARVD/C. Each of these patients had increased RV signal on MDE-MRI. None of the patients without ARVD/C had any abnormalities either on histopathology or on MDE-MRI. Electrophysiologic testing revealed inducible sustained ventricular tachycardia (VT) in six of the eight ARVD/C patients with delayed enhancement, compared with none of the ARVD/C patients without delayed enhancement (p = 0.01). Noninvasive detection of RV myocardial fibro-fatty changes in ARVD/C is possible by MDE-MRI. Magnetic resonance imaging findings had an excellent correlation with histopathology and predicted inducible VT on programmed electrical stimulation, suggesting a possible role in evaluation and diagnosis of patients with suspected ARVD/C.

Original languageEnglish
Pages (from-to)98-103
Number of pages6
JournalJournal of the American College of Cardiology
Volume45
Issue number1
DOIs
StatePublished - Jan 4 2005
Externally publishedYes

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Arrhythmogenic Right Ventricular Dysplasia
Fibrosis
Magnetic Resonance Imaging
Heart Ventricles
gadodiamide
Advisory Committees
Ventricular Tachycardia
Biopsy

ASJC Scopus subject areas

  • Nursing(all)

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Noninvasive detection of myocardial fibrosis in arrhythmogenic right ventricular cardiomyopathy using delayed-enhancement magnetic resonance imaging. / Tandri, Harikrishna; Saranathan, Manoj; Rodriguez, E. Rene; Martinez, Claudia; Bomma, Chandra; Nasir, Khurram; Rosen, Boas; Lima, João A C; Calkins, Hugh; Bluemke, David A.

In: Journal of the American College of Cardiology, Vol. 45, No. 1, 04.01.2005, p. 98-103.

Research output: Contribution to journalArticle

Tandri, Harikrishna ; Saranathan, Manoj ; Rodriguez, E. Rene ; Martinez, Claudia ; Bomma, Chandra ; Nasir, Khurram ; Rosen, Boas ; Lima, João A C ; Calkins, Hugh ; Bluemke, David A. / Noninvasive detection of myocardial fibrosis in arrhythmogenic right ventricular cardiomyopathy using delayed-enhancement magnetic resonance imaging. In: Journal of the American College of Cardiology. 2005 ; Vol. 45, No. 1. pp. 98-103.
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AU - Nasir, Khurram

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