Objective:

To assess the ability of CMR to detect structural abnormalities in patients referred for PVCs and to determine predictive factors.

Approach:

• Study Population: 200 consecutive patients referred for CMR with PVCs were retrospectively included after an initial workup.
• Data Collection: Clinical and laboratory data were collected from electronic medical records, and PVC morphology was classified.
• CMR Acquisitions: CMR examinations were performed using 1.5 Tesla and 3 Tesla magnets, assessing LV and RV function and wall motion.

Key Findings:

• CMR revealed structural abnormalities in 92 patients (46% of cases): nonischemic fibrosis (n = 53, 26.5%), ischemic fibrosis (n = 18, 9%), mixed fibrosis (n = 4, 2%), and 4 (2%) cardiomyopathies.
• Predictive factors for structural abnormalities included age (odds ratio [OR]: 1.03; p = 0.016), male sex (OR: 2.48; p = 0.019), diabetes (OR: 5.02; p = 0.010), smoking (OR: 2.09; p = 0.047), known cardiomyopathy (OR: 3.24; p = 0.006), pleomorphic PVCs (OR: 2.48; p = 0.051), and the absence of a decrease in PVC frequency during exercise (OR: 0.24; p < 0.001).
• Young, nondiabetic patients with normal echocardiography and monomorphic PVCs that decreased with effort had normal CMR findings.

Interpretation:

CMR is useful in investigating PVCs, detecting structural abnormalities that may not be identified in initial assessments.

Limitations:

• The study was retrospective and conducted at a single center.
• Findings may not be generalizable to all patient populations.

Conclusion:

CMR can detect structural heart disease in PVC patients, with specific predictive factors identified.