THE IMPORTANCE OF CARDIAC MAGNETIC RESONANCE IMAGING IN THE ASSESSMENT OF THE RISK OF CARDIAC ARRHYTHMIAS IN PATIENTS WITH ARTERIAL HYPERTENSION

Abstract

Objective: Arterial hypertension leads to organ changes, including left ventricular hypertrophy. The increased mass of left ventricle increases the risk of cardiac arrhythmias, which enhances the risk of sudden cardiac death. Cardiac magnetic resonance imaging (CMRI) can identify the presence of myocardial fibrosis by assessing late gadolinium enhancement (LGE). The aim of the study was to assess the relationship between the presence of late gadolinium enhancement at the right ventricular insertion point (RVIP) determined by CMRI and the occurrence of cardiac arrhythmias in patients with arterial hypertension. Design and method: 30 patients with essential hypertension were qualified for the study, 18 men and 12 women, the average age of the subjects was 55.5 ± 12.4 years. All subjects underwent cardiac magnetic resonance imaging and 24-hour Holter ECG monitoring. Based on the presence of LGE at the right ventricular insertion point, assessed by CMRI, the subjects were divided into two subgroups. The first subgroup consisted of subjects with LGE at the right ventricular insertion point (RVIP + subgroup), while the second subgroup consisted of subjects without LGE at the right ventricular insertion point (RVIP - subgroup). Results: Subjects with LGE at the right ventricular insertion point were characterized by higher maximum and minimum heart rates in 24-hour Holter ECG recordings compared to subjects without LGE at the right ventricular insertion point (p < 0.05). In subjects with LGE at the right ventricular insertion point, Holter ECG evaluation revealed a statistically significantly higher number of single premature supraventricular beats, single premature ventricular beats and supraventricular tachycardias compared to subjects without LGE at the right ventricular insertion point (p < 0.05). The regression analysis performed showed that a longer time from the diagnosis of hypertension and the occurrence of LGE at the right ventricular insertion point assessed using CMRI are independent risk factors for cardiac arrhythmias (p < 0.05). Conclusions: Cardiac magnetic resonance imaging by identifying of late gadolinium enhancement at the right ventricular insertion point may be a useful diagnostic method in assessing the risk of cardiac arrhythmias in a group of patients with arterial hypertension.