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. 2021 Jun;37(6):2037-2047.
doi: 10.1007/s10554-021-02166-7. Epub 2021 Feb 7.

Cardiac magnetic resonance in patients with ARVC and family members: the potential role of native T1 mapping

Georgios Georgiopoulos #  1 , Mattia Zampieri #  2 , Silvia Molaro  3 , Anna Chaloupka  4 , Alberto Aimo  5   6   7 , Barbara Barra  8 , Leema Roberts  9 , Laura Monje-Garcia  10 , Colin Evans  11 , Nabeel Sheikh  12   13 , Rachel Bastiaenen  14   15 , Michael Cooklin  16 , Pier-Giorgio Masci  17 , Gerald Carr-White  18   19 , Gherardo Finocchiaro #  20   21 , Amedeo Chiribiri #  22   23
Affiliations

Cardiac magnetic resonance in patients with ARVC and family members: the potential role of native T1 mapping

Georgios Georgiopoulos et al. Int J Cardiovasc Imaging. 2021 Jun.

Abstract

Left ventricular (LV) involvement in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is not evaluated in the revised Task Force Criteria, possibly leading to underdiagnosis. This study explored the diagnostic role of myocardial native T1 mapping in patients with ARVC and their first-degree relatives. Thirty ARVC patients (47% males, mean age 45 ± 27 years) and 59 first-degree relatives not meeting diagnostic criteria underwent CMR with native T1 mapping. C MR was abnormal in 26 (87%) patients with ARVC. The right ventricle was affected in isolation in 13 (43%) patients. Prior to T1 mapping assessment, 2 (7%) patients exhibited isolated LV involvement and 11 (36%) patients showed features of biventricular disease. Left ventricular involvement was manifest as detectable LV late gadolinium enhancement (LGE) in 12 out of 13 cases. According to pre-specified inter-ventricular septal (IVS) T1 mapping thresholds, 11 (37%) patients revealed raised native T1 values including 5 out of the 17 patients who would otherwise have been classified as exhibiting a normal LV by conventional imaging parameters. Native septal T1 values were elevated in 22 (37%) of the 59 first-degree relatives included. Biventricular involvement is commonly observed in ARVC; native myocardial T1 values are raised in more than one third of patients, including a significant proportion of cases that would have been otherwise classified as exhibiting a normal LV using conventional CMR techniques. The significance of abnormal T1 values in first-degree relatives at risk will need validation through longitudinal studies.

Keywords: ARVC; Diagnosis; Late gadolinium enhancement; T1 mapping.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart and main characteristics of the patients with arrhythmogenic right ventricular cardiomyopathy (ARVC)
Fig. 2
Fig. 2
Abnormal findings by conventional cardiac magnetic resonance (CMR) imaging and native T1 mapping imaging
Fig. 3
Fig. 3
Flow chart and main characteristics of first-degree relatives of patients with ARVC
See this image and copyright information in PMC

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