According to the literature data idiopathic heart rhythm and conduction disturbances (CD) can be the only clinical manifestation of myocardial inflammation. The endomyocardial biopsy (EMB) – a gold standard of myocarditis diagnosis – can be performed in a very low proportion of patients (mostly in patients with dilated cardiomyopathy) because of the risk of complications. In the cases of idiopathic CD the only alternative diagnostic approach in detecting the inflammation in myocardium is cardiovascular magnetic resonance (CMR). The aim of our work was to evaluate...

There were included 30 ptswith conduction disturbances(CD) and structurally normal heart and 25 ptswith clinical syndrome of dilated cardiomyopathy (DCMP). Baseline charecteristics are presented in Table 1. In DCMP ptscoronary angiography excluded coronary artery disease. For morphological evaluation endomyocardial biopsy (EMB) in all DCMP ptswas performed. EMB confirmed active inflammation in 16 (64%) DCMP patients(Figure 1 A,B). In 4(16%) pts EMB revealed resolved myocarditis with huge areas of fibrosis (Figure 1C). In 5 cases (25%) the sighs of active inflammation were not detected and the...

In pts with CD the most frequent CMR phenomenon was EGE detected in 10 (33.3%) pts in 3-10 segments. ME was detected in 6 (20%) pts in 2-7 segments. None of CDpts revealed LGE at CMR. 4 (13.3%) pts had both EGE and ME which matched topographically in ventricular septum (Figure 2 A,B). The most frequent finding in these pts was LGE – in 12 pts (48%), ME was found in 10 pts (40%), sighs of EGE in 7 pts (28%). CMR proved the diagnosis...

Detection of ME and EGE may be the most useful in detection of myocardial inflammation in pts with CD and structurally normal heart. The sensitivity of “LLC” is 50%, specificity 100%. LGE in pts with clinical syndrome of dilated cardiomyopathy is associated with ventricular arrhythmias.