Cardiac magnetic resonance imagingas the methodic of the diagnostic idiopathic violations of rhythm

Abstract

Present the results of a clinical study of patients with heart rate disorders. We propose to use magnetic resonance imaging of the heart in patients with idiopathic cardiac rate disorders of frequent ventricular and supraventricular extrasystole type, especially if myocarditis is suspected. The perspectives for the application of this method in modern cardiology are consideredis suspected to detect early myocarditis signs and to determine the optimal tactics for further management of such patients. Performing cardiac magnetic resonance imaging in this category of patients allowed to establish the cause of arrhythmias in 2/3 of the patients. Magnetic resonance signs of myocarditis were found in 16 patients examined; signs of cardiomyoma – in 4; signs of hypertrophic cardiomyopathy – in 3 patients; dilatation – in 1; signs of an isolated non- compact myocardium of the left ventricle – in 4; local fibrosis in the apex of the heart probably of post-infarction genesis – in 1, diverticula of the left ventricle wall – in 2; local fibrosis in the apex of the heart of most likely post-traumatic genesis – in 1; one patient had a site of intramyocardial fibrosis in the middle sections of the posterior suburban area; one had signs of arrhythmogenic dysplasia of the right ventricle; in one subject there was myxomatous degeneration of the mitral valve with regurgitation; and in one – an anomalous course of the anterior interventricular artery.

Keywords

cardiac magnetic resonance imaging / gadolinium / diagnostic of the arrhythmias / heart rhythm disturbances / ventricular extrasystoles / supraventricular extrasystoles / idiopathic arrhythmias / myocarditis

References

[1] Благова, О.В. Клинико-морфологический подход к диагностике «идиопатических» аритмий и синдрома ДКМП как основа дифференцированной терапии. Ч. I (диагностика) / О.В. Благова, А.В. Недоступ, Е.А. Коган // Рациональная фармакотерапия в кардиологии. – 2014. – № 10 (1). – С. 62–72.

[2] Ларина, В.Н. Внезапная сердечная смерть / В.Н. Ларина, Е.В. Кудина // Поликлиника. Спецвыпуск № 1 «Кардиолог сегодня». – 2018. – С. 2 –7.

[3] Синицын, В.Е. Возможности магнитно-резонансной томографии в диагностике кардиомиопатии / В.Е.Синицын, Е.А. Мершина, О.М. Ларина // Клин. и эксперимент. хирургия. – 2014. – № 1. – С. 54–63.

[4] Abdel-Aty, H. Diagnostic performance of cardiovascular magnetic resonance in patients with suspected acute myocarditis: comparison of different approaches / H. Abdel-Aty [et al.] // J. Am. Coll. Cardiol. – 2005. – Vol. 45. – Р. 1815–1822.

[5] Angelini, A. Myocarditis mimicking acute myocardial infarction: role of endomyocardial biopsy in the differential diagnosis / A.Angelini [et al.] // Heart.– 2000. – Vol. 84. – Р. 245–250.

[6] Aquaro, G.D. Cardiac magnetic resonance predicts outcome in patients with premature ventricular complexes of left bundle branch block morphology / G.D. Aquaro [et al.] // J. Am. Coll. Cardiol. –2010. – Vol. 56. – № 15. – Р. 1235–1243.

[7] Barbier, C.E. Myocardial scars more frequent than expected Magnetic resonance imaging detects potential risk group / C.E. Barbier [et al.] // J. Am. Coll. Cardiol. – 2006. – Vol. 48. – Р. 765–771.

[8] Cooper, L.T. Jr. Myocarditis / L.T. Jr. Cooper // N. Engl. J. Med. – 2009. – Vol. 360. – Р. 1526–1538.

[9] Hundley, W.G. ACCF/ACR/AHA/NASCI/SCMR 2010 Expert consensus document on cardiovascular magnetic resonance: a report of the American college of cardiology foundation task force on the expert consensus documents / W.G. Hundley [et al.] // Circulation. – 2010. – Vol. 121. – Р. 2462–2508.

[10] Kindermann, I. Update on myocarditis / I. Kindermann [et al.] // J. Am. Coll. Cardiol. – 2012. – Vol. 59. – № 9. – Р. 779–792.

[11] Mahrholdt, H. Cardiovascular magnetic resonance assessment of human myocarditis: a comparison to histology and molecular pathology / H. Mahrholdt [et al.] // Circulation. – 2004. – Vol. 109. – Р. 1250–1258.

[12] Matthias, G. Cardiovascular Magnetic Resonancein Myocarditis A JASS White Paper / G. Matthias [et al.] //J. Am. Coll. Cardiol. – 2009 Apr 28. – Vol. 53. – № 17. – P. 1475–1487.

[13] McCrohon, J.A. Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium- enhanced cardiovascular magnetic resonance / J.A. McCrohon [et al.] // Circulation. – 2003. – Vol. 108. – Р. 54–59.

[14] Punja, M. Electrocardiographic manifestations of cardiac infectious-inflammatory disorders / M. Punja [et al.] //Am. J. Emerg. Med. – 2010. – Vol. 28. – Р. 367–377.

RIGHTS & PERMISSIONS

Getman S.I., Kuryanovich E.N.