Muresan L, et al. - Herein, researchers resolved to discern the associations between ventricular arrhythmias, conduction disorders and myocardial fibrosis via delayed-enhancement magnetic resonance imaging (DE-MRI) in patients with systemic sclerosis. Myocardial fibrosis could be detected through delayed-enhancement magnetic resonance imaging in a high percentage of scleroderma patients. Its presence did not exert any impact on the ventricular arrhythmia burden and severity or the presence of conduction disorders, with the exception of diffuse myocardial fibrosis, which imparted a modest influence on the total number of premature ventricular contractions (PVCs)/24 hours.

Methods

• During this trial, 12-lead electrocardiogram (ECG), 24-hour Holter ECG monitoring, transthoracic echocardiography, and cardiac DE-MRI were carried out in 36 patients with diffuse or limited cutaneous scleroderma.
• Among these, 33 candidates recieved gadolinium administration.

Results

• Experts obtained high-quality DE-MRI scans in 30 patients.
• They identified myocardial fibrosis in 25 patients (83.3%).
• Ventricular arrhythmias or conduction disorders were reported in 18 patients (60%).
• No prominent variation was discovered in the ventricular arrhythmia burden (the total number of premature ventricular contractions [PVCs]/24 hours) (48 ± 304 vs. 69 ± 236, P=0.97), ventricular arrhythmia severity (couplets, triplets, runs) on Holter ECG, or in the presence of conduction disorders (36% vs. 40%, P=0.86) between patients with and without myocardial fibrosis.
• The univariate analysis unveiled a weak connection between diffuse fibrosis with the number of PVCs/24 hours (R² = 0.157, P=0.03).
• For speculating the presence of diffuse fibrosis on DE-MRI (area under the curve = 0.640), a number of at least 597 PVCs/24 hours exhibited a sensitivity of 60% and a specificity of 92%.