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Arrhythmogenic right ventricular cardiomyopathy mimics: role of cardiovascular magnetic resonance.

Quarta, G; Husain, SI; Flett, AS; Sado, DM; Chao, CY; Tomé Esteban, MT; McKenna, WJ; Pantazis, A; Moon, JC (2013) Arrhythmogenic right ventricular cardiomyopathy mimics: role of cardiovascular magnetic resonance. J Cardiovasc Magn Reson, 15. p. 16. ISSN 1532-429X https://doi.org/10.1186/1532-429X-15-16
SGUL Authors: Tome, Maria Teresa

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Abstract

BACKGROUND: Cardiovascular magnetic resonance (CMR) is commonly used in patients with suspected arrhythmogenic right ventricular cardiomyopathy (ARVC) based on ECG, echocardiogram and Holter. However, various diseases may present with clinical characteristics resembling ARVC causing diagnostic dilemmas. The aim of this study was to explore the role of CMR in the differential diagnosis of patients with suspected ARVC. METHODS: 657 CMR referrals suspicious for ARVC in a single tertiary referral centre were analysed. Standardized CMR imaging protocols for ARVC were performed. Potential ARVC mimics were grouped into: 1) displacement of the heart, 2) right ventricular overload, and 3) non ARVC-like cardiac scarring. For each, a judgment of clinical impact was made. RESULTS: Twenty patients (3.0%) fulfilled imaging ARVC criteria. Thirty (4.6%) had a potential ARVC mimic, of which 25 (3.8%) were considered clinically important: cardiac displacement (n=17), RV overload (n=7) and non-ARVC like myocardial scarring (n=4). One patient had two mimics; one patient had dual pathology with important mimic and ARVC. RV overload and scarring conditions were always thought clinically important whilst the importance of cardiac displacement depended on the degree of displacement from severe (partial absence of pericardium) to epiphenomenon (minor kyphoscoliosis). CONCLUSIONS: Some patients referred for CMR with suspected ARVC fulfil ARVC imaging criteria (3%) but more have otherwise unrecognised diseases (4.6%) mimicking potentially ARVC. Clinical assessment should reflect this, emphasising the assessment and/or exclusion of potential mimics in parallel with the detection of ARVC major and minor criteria.

Item Type: Article
Additional Information: © 2013 Quarta et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Arrhythmogenic Right Ventricular Dysplasia, Diagnosis, Differential, Electrocardiography, Humans, London, Magnetic Resonance Imaging, Cine, Myocardium, Predictive Value of Tests, Prognosis, Retrospective Studies, Tertiary Care Centers, Ventricular Function, Left, Ventricular Function, Right, Myocardium, Humans, Arrhythmogenic Right Ventricular Dysplasia, Diagnosis, Differential, Magnetic Resonance Imaging, Cine, Electrocardiography, Prognosis, Retrospective Studies, Predictive Value of Tests, Ventricular Function, Left, Ventricular Function, Right, London, Tertiary Care Centers, Nuclear Medicine & Medical Imaging, 1102 Cardiovascular Medicine And Haematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cardiac (INCCCA)
Journal or Publication Title: J Cardiovasc Magn Reson
ISSN: 1532-429X
Language: eng
Dates:
DateEvent
11 February 2013Published
21 January 2013Accepted
Publisher License: Creative Commons: Attribution 2.0
Projects:
Project IDFunderFunder ID
NF-SI-0509-10230Department of HealthUNSPECIFIED
PG/11/32/28728British Heart FoundationUNSPECIFIED
UNSPECIFIEDDepartment of HealthUNSPECIFIED
PubMed ID: 23398958
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107469
Publisher's version: https://doi.org/10.1186/1532-429X-15-16

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