Original article Arrhythmogenic Cardiomyopathy. Patterns of Ventricular Involvement Using Cardiac Magnetic Resonance Begon ˜a Igual, a,b, * Esther Zorio, a,b Alicia Maceira, a Jordi Estornell, a Marı ´a P. Lopez-Lereu, a Jose V. Monmeneu, a Anastasio Quesada, a,b Josep Navarro, c Fernando Mas, a and Antonio Salvador b a Unidad de Imagen Cardiaca, ERESA, Unidad de Muerte Su ´bita Familiar, Hospital Universitari i Polite `cnic La Fe, Valencia, Spain b Servicio de Cardiologı´a, Hospital Universitari i Polite `cnic La Fe, Valencia, Spain c Servicio de Cardiologı´a, Hospital de Manises, Manises, Valencia, Spain Rev Esp Cardiol. 2011;64(12):1114–1122 Article history: Received 14 December 2010 Accepted 1 July 2011 Available online 24 October 2011 Keywords: Arrhythmogenic cardiomyopathy Cardiovascular magnetic resonance Late gadolinium enhancement A B S T R A C T Introduction and objectives: Biventricular arrhythmogenic cardiomyopathy and left dominant arrhyth- mogenic cardiomyopathy forms had recently been included in the spectrum of arrhythmogenic cardiomyopathy. The aim of the study was to describe, using cardiovascular magnetic resonance, the patterns of ventricular involvement as well as late gadolinium enhancement in these conditions. Methods: Medical databases and records from the cardiology units of 3 hospitals were reviewed to obtain data from patients with arrhythmogenic cardiomyopathy. Results: Twenty-six consecutive patients were included (40 [16] years, 16 males). Right ventricle involvement was present in 19 patients (73%). Among them, 13 patients (50%) had volumes over the upper limit of normality, 11 (42%) patients had late gadolinium enhancement in right ventricle and 6 patients (23%) had just mild involvement with wall motion abnormalities or microaneurysms. Left ventricle involvement was present in 24 patients (92%), all of them with late gadolinium enhancement. In 15 patients (57%) left ventricular systolic dysfunction was observed, and dilatation in 3 patients (11%). Late gadolinium enhancement was more frequent in the inferior, lateral, and inferolateral walls (65%, 57%, and 61% of patients, respectively) while septum was seldom affected (26% of cases). The pattern of late gadolinium enhancement was mainly subepicardial (46% of patients) or transmural (19%), and was intramyocardial in only 12% of the cases. Conclusions: In this sample, left ventricle involvement is very common. The most frequent finding was late gadolinium enhancement, while the least frequent was dilatation. The pattern of late gadolinium enhancement was more frequently subepicardial and located in the inferior and inferolateral walls. ß 2011 Sociedad Espan ˜ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L. All rights reserved. Resonancia magne ´ tica cardiaca en miocardiopatı´a arritmoge ´ nica. Tipos de afeccio ´n y patrones de realce tardı´o de gadolinio Palabras clave: Miocardiopatı ´a arritmoge ´ nica Cardiorresonancia magne ´ tica Realce tardı ´o de gadolinio R E S U M E N Introduccio ´n y objetivos: La miocardiopatı ´a arritmoge ´ nica biventricular y la miocardiopatı ´a arritmoge ´ nica izquierda han sido incluidas recientemente en el espectro de la miocardiopatı ´a arritmoge ´ nica. El objetivo del estudio es describir con cardiorresonancia magne ´ tica el tipo de afeccio ´n observada y describir los patrones de realce tardı ´o de gadolinio. Me ´todos: Se revisaron las bases de datos y la historia clı ´nica informatizada de tres hospitales, para obtener datos de enfermos consecutivos con miocardiopatı ´a arritmoge ´ nica. Resultados: Se incluyo ´a 26 pacientes consecutivos, con una media de edad de 40 Æ 16 an ˜os, de los que 16 eran varones (67%). Se observo ´ afeccio ´n de ventrı ´culo derecho en 19 pacientes (73%), con volu ´ menes aumentados en 13 pacientes (50%), 11 pacientes (42%) con realce tardı ´o de gadolinio en ventrı ´culo derecho y 6 (23%) presentaban u ´ nicamente alteraciones de la contractilidad segmentaria. Se observo ´ afeccio ´n de ventrı ´culo izquierdo en 24 pacientes (92%), todos con realce tardı ´o de gadolinio; 15 pacientes (57%) presentaron disfuncio ´n sisto ´ lica ventricular izquierda. En 3 pacientes (11%) se observo ´ dilatacio ´n de ventrı ´culo izquierdo y ninguno de ellos fue diagnosticado de miocardiopatı ´a arritmoge ´ nica izquierda. La localizacio ´n del realce tardı ´o de gadolinio fue predominantemente inferior (65%), inferolateral (61%) y lateral (57%), mientras que la localizacio ´n septal fue menos frecuente (26%). El patro ´n de realce tardı ´o de gadolinio fue fundamentalmente epica ´ rdico (46%) y transmural (19%), raramente intramioca ´ rdico (12%). Conclusiones: En esta muestra, la afeccio ´n del ventrı ´culo izquierdo es muy frecuente; el hallazgo observado en el mayor nu ´ mero de pacientes fue el realce tardı ´o de gadolinio y el menos frecuente, la * Corresponding author: Unidad de Imagen Cardiaca, ERESA, Unidad de Muerte Su ´ bita Familiar, Hospital Universitari i Polite ` cnic La Fe, Bulevar Sur s/n, 46026 Valencia, Spain. E-mail address: bigual@eresa.com (B. Igual). 1885-5857/$ – see front matter ß 2011 Sociedad Espan ˜ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L. All rights reserved. doi:10.1016/j.rec.2011.07.013 Document downloaded from https://www.revespcardiol.org/, day 18/08/2022. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. Document downloaded from https://www.revespcardiol.org/, day 18/08/2022. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.