Abstract：
Premature ventricular contractions (PVCs) are a common form of arrhythmic events, often representing an idiopathic and benign condition without further therapeutic interventions. However, in certain circumstances PVCs may represent the epiphenomenon of a concealed structural heart disease (SHD). Surface 12‑leads EKG and 24-h dynamic EKG are necessary to assess their main characteristics such as site of origin, frequency and complexity. Echocardiography represents the first-line imaging tool recommended to evaluate cardiac structures and function. Cardiac Magnetic Resonance (CMR) is recognized as a superior modality for detecting structural cardiac alterations, that might evade detection by conventional echocardiography. Moreover, in specific populations such as athletes, CMR may have a crucial role to exclude a concealed SHD and the risk of serious arrhythmic events during sport activity. Some clinical characteristics such as male sex, older age or family history of sudden cardiac death (SCD) or cardiomyopathy, and some electrocardiographic features of PVCs, in particular a right branch bundle block (RBBB) with superior/intermediate axis morphology, the reproducibility of VAs during exercise test (ET) or the evidence of complex ventricular arrhythmias, may warrant a CMR evaluation, due to the high probability of SHD. In this systematic review our objective was to provide an exhaustive overview on the role of CMR in detecting a concealed SHD in patients with high daily burden of PVCs and a normal echocardiographic evaluation, paving the way for a more extensive utilization of CMR in presence of certain high-risk clinical and/or EKG features identified during the diagnostic workup.
摘要：
室性早搏（PVC）是心律失常事件的常见形式，通常代表特发性和良性疾病，没有进一步的治疗干预。然而,在某些情况下,PVCs可能代表隐匿性结构性心脏病(SHD)的附带现象.Surface12-leadsEKG和24小时动态EKG是必要的，以评估其主要特征，如原产地，频率和复杂性。超声心动图代表推荐用于评估心脏结构和功能的一线成像工具。心脏磁共振（CMR）被认为是检测结构性心脏改变的优越模式，这可能会逃避传统超声心动图的检测。此外，在特定人群中，如运动员，CMR可能对排除隐匿的SHD和运动期间严重心律失常事件的风险具有关键作用。一些临床特征，如男性，年龄较大或有心源性猝死（SCD）或心肌病的家族史，和PVCs的一些心电图特征，特别是具有上/中轴形态的右分支束阻滞（RBBB），运动试验（ET）期间VA的可重复性或复杂室性心律失常的证据，可能需要进行CMR评估，由于SHD的高概率。在这篇系统综述中，我们的目标是提供一个详尽的概述，即CMR在检测每天高负担的PVCs患者的隐匿性SHD和正常的超声心动图评估中的作用。在诊断检查过程中发现的某些高风险临床和/或EKG特征的情况下，为更广泛地利用CMR铺平了道路。
