INCIDENCE OF MYOCARDIAL FIBROSIS ON CARDIAC MAGNETIC RESONANCE IMAGING IN PATIENTS WITH ATYPICAL ELECTROCARDIOGRAPHY CHANGES

Abstract

Objectives: Ventricular fibrosis evaluation by cardiac magnetic resonance imaging (CMR) has been proposed as a risk factor for developing cardiomyopathies, arrhythmias and a potential indicator for sudden cardiac death (SCD). The objective of the study was to determine the incidence of myocardial fibrosis on CMR in patients who had normal invasive and/or non-invasive cardiology investigations but had subtly abnormal ECGs.

Methodology: Study was conducted at Cardiac MRI department of AFIC after the approval of ethical board. One hundred and thirty patients, between the ages of 20 to 55 years, presenting for the evaluation of chest pain, shortness of breath, palpitations and atypical changes on ECG, were included in the study while patients with acute LVF, myocardial infarction, infiltrative disorders and cardiomyopathies were excluded. Myocardial fibrosis was evaluated on CMR with a variety of sequences like steady state free precession (SSFP), parametric T1 and T2 mapping and late gadolinium enhancement (LGE). Data was stored and analyzed on SPSS-23.

Results: The mean age of the patients was 34.2 ± 9.65 years among which 127 (97.7%) were males while 3 (2.3%) were females. Fifteen (11.5%) patients were hypertensive while 5 (3.8%) patients were diabetic. The incidence of myocardial fibrosis among our study sample was 43.1% as 56 patients had confirmed LGE or raised parametric T1 map times on CMR.

Conclusion: CMR late gadolinium enhancement (LGE) and T1 mapping can pick myocardial fibrosis in patients with abnormal ECGs and it can help in identifying patients susceptible to cardiomyopathies and arrhythmias at an early stage for better future risk stratification.