Evaluation of Cardiac Function and Structural Changes in Children with Tachycardia via Cardiac Magnetic Resonance Imaging: A Case Series Study

Evaluation of Cardiac Function and Structural Changes in Children with Tachycardia via Cardiac Magnetic Resonance Imaging: A Case Series Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluation of Cardiac Function and Structural Changes in Children with Tachycardia via Cardiac Magnetic Resonance Imaging: A Case Series Study Yanfeng Yang, Lu Guo, Bo Yu, Ying Xiong, Yonghong Guo, Yizhou Wen, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7326756/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract This case series investigated cardiac function and structural alterations in pediatric patients with tachycardia via cardiac magnetic resonance imaging (CMR). Fifty-two children were enrolled, including 37 in the premature ventricular contraction (PVC) group, 11 in the premature atrial contraction (PAC) group and 4 in the PSVT group. ECG, 24-h Holter ECG-monitoring, echocardiogram and CMR were performed. The results revealed that in the PVC and PAC groups, 16 patients (PVC/PAC) had LGE, whereas 32 did not. No significant baseline differences existed between the PVC/PAC groups or LGE/no-LGE groups ( P > 0.05). LV EF, LV EDVi, and CO did not significantly differ between the PVC and PAC groups. Compared with LGE(-) patients, LGE(+) patients had a greater arrhythmia burden ( P < 0.05) and significantly lower LV SV, LV EF, and CO versus LGE(-) (all P < 0.05). Compared with the reference cohort, the cohort had lower LV SV, LV Svi, and LV EF values and higher LV ESVi values(all P < 0.05). Conclusion: Tachyarrhythmic children exhibit reduced LV SV, LV Svi, and LV EF. PAC impairs ventricular function. CMR provides valuable clinical insights into pediatric arrhythmias. Our research is registered in the Chinese Clinical Trials Registry on December 13, 2021. Registration number: ChiCTR2100054326 URLhttps://www.chictr.org.cn/showprojEN.html?proj=133543 Cardiac Magnetic Resonance late gadolinium enhancement premature ventricular contractions premature atrial contractions Paroxysmal superventricular tachycardia Figures Figure 1 Figure 2 1. Introduction In recent years, pediatric arrhythmias have emerged as a distinct clinical domain within childhood cardiovascular medicine. These rhythm disturbances are categorized hemodynamically according to their hemodynamic effects into tachyarrhythmias and bradyarrhythmias( 1 ). Tachyarrhythmias include premature supraventricular beats (PSVBs) and premature ventricular contractions (PVCs). PSVBs originate from atrial tissue or the atrioventricular (AV) junction, and these ectopic beats are predominantly idiopathic and asymptomatic in pediatric populations( 1 ). Additionally, premature ventricular contractions are usually idiopathic and not associated with symptoms. However, when documented, underlying cardiac disease or more complex arrhythmias must be excluded. Doppler echocardiography and myocardial injury markers are widely used in the diagnostic evaluation of arrhythmia. However, since children with arrhythmias often lack apparent cardiovascular pathology, significant research has focused on uncovering their underlying, potentially dangerous causes. Cardiac magnetic resonance (CMR) imaging is an advanced, multifaceted, noninvasive imaging method that accurately assesses cardiac muscle structure and function. It has a good ability to locate the source of abnormal discharge and guide electrophysiological treatment. CMR has high spatial resolution and allows for clear scar delineation and quantification, which has prognostic value in the determination of arrhythmias( 2 ). Additionally, CMR provides more accurate detection of the left ventricular ejection fraction (LVEF) than does compared with transthoracic echocardiography as it is not limited by poor acoustic windows( 3 ). The Late Gadolinium enhancement (LGE) has excellent histological correlation, so it is a powerful tool for assessing the presence of scars( 4 ). The distribution of LGE assists in the determination of the various causes of cardiomyopathies, and serves as a prognostic marker for sudden cardiac death in adults( 5 ). T2-weighted imaging for the assessment of myocardial edema is used to assess myocarditis( 6 ). Smith et al. reports that hypertrophic cardiomyopathy patients with ventricular tachycardia had more LV myocardial segments with LGE than patients without Ventricular Tachycardia. Joseph A et al. reported that compared with patients without ventricular tachycardia, patients with hypertrophic Cardiomyopathy with ventricular tachycardia have a greater LV mass index, more hypertrophied segments and greater maximum septal thickness( 7 ). Researchers at Xi'an Jiaotong University implemented a three-dimensional bidomain cardiac model combined with deep learning algorithms (e.g., long short-term memory, LSTM) to achieve inverse mapping from body surface potentials to myocardial electrical activity. Their simulated data demonstrated an 84.61% correlation with clinical CMR findings, providing critical evidence for preprocedural ablation pathway planning( 8 ). Research has demonstrated significant differences in CMR findings in hypertrophic cardiomyopathy children with ventricular arrhythmia. In our study, we explored CMR findings in children with tachyarrhythmia, to identify the potential etiology of children with tachyarrhythmia, and evaluate the cardiac function of these children, providing a reference for the treatment of children with arrhythmia. 2. Materials and methods 2.1 Patients and methods Children with tachyarrhythmia (including premature atrial contractions, paroxysmal superventricular tachycardia and premature ventricular contractions) at the Chengdu Women's and Children's Central Hospital from July 2022 to October 2023 were included. Our research was approved by the Ethics Committee of the Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China. All the children enrolled in this trial providesd informed consent forms signed by their parents or guardians. All the children underwent the ECG, 24-h Holter ECG-monitoring, and echocardiogram. The type of arrhythmia was assessed via ECG and quantified via 24-h Holter ECG-monitoring. All examinations were performed by experienced physicians, CMR imaging was performed via a Signa 3.0T, and all the images were obtained via a steady-state free precession (SSFP) pulse sequence. Images were obtained while the participants held their breath whenever possible. Young children unable to be properly instructed were sedated and images were obtained while they were breathing freely. All image postprocessing and data analysis was performed by two experienced radiologists. Visual semiquantitative scoring system for grading LGE patterns in cardiac magnetic resonance imaging. This study was approved by the Ethics Committee of the Chengdu Women's and Children's Central Hospital (NO.2021 − 118) and all patients enrolled in this trial had informed consent forms signed by their parents or guardians. This study was conducted in compliance with the ethical principles outlined in the Ethical Review Measures for Biomedical Research Involving Human Subjects (2016) issued by the National Health and Family Planning Commission of the People's Republic of China and the Declaration of Helsinki, as well as relevant Chinese laws and regulations. 2.2 Inclusion and exclusion criteria Children who were diagnosed with tachyarrhythmia via Holter monitoring and who underwent examination and cardiac function analysis at the time of initial diagnosis were enrolled in our study. Those who met the following criteria were excluded: ( 1 ) ultrasonic cardiogram or Cardiovascular CT revealed structural heart disease; ( 2 ) the child had been diagnosed with cardiomyopathy, abnormal coronary origin, hypertension or other diseases or a family history of sudden death; ( 3 )24-h Holter monitoring revealed that the PVC or PAC load was less than 1%; and ( 4 ) failure to complete cardiac magnetic resonance examination or poor image quality led to unreliable results. 2.3 Data collection The relevant information, including baseline information, symptoms, ECG, 24-h Holter ECG-monitoring, echocardiogram and CMR results, included the left atrial diameter, ventricular end diastolic dimension, aortic root width, ejection fraction (EF), stroke volume (SV), stroke volume index (SVi), left ventricular mass (LVM), cardiac output (CO), cardiac index (CI), end-diastolic volume index (EDVi), end-systolic volume index (ESVi), peak ejection rate, peak filling rate, LGE and location, abnormal perfusion and location. 2.4 Data analysis All the date were analyzed with SPSS statistical software (version 26; SPSS, Chicago, IL, USA). Normally distributed measurement data are presented as the mean ± S.D, and Student’s t test was used to test the significance of the differences among the compared samples. Nonnormally distributed measurement data are presented as the median (IQR), and the Mann–Whitney U test was used for the analyses. Count data were analyzed by means of the chi-square test. P < 0.05 was considered significantly different. All figures were drawn with GraphPad Prism (version 8.0; GraphPad Software, Chicago, IL, USA). 3. Results 3.1 A summary of patient characteristics at the time of qualification for CMR is presented in Table 1. Table 1. Baseline characteristics of all children. Feature Study Group n = 52 Mean age, (years, mean ± SD) 8.0±3.9 Male sex, %(n) 52.3(23) BSA(m 2 ) 1.0±0.37 PVCs, %(n) 71.2(37) PACs, %(n) 21.2(11) PSVT, %(n) 7.7(4) PVC/PACs number (mean ± SD) 15673±13153 PVC/PACs % (mean ± SD) 12.4±8.6 Symptoms, %(n) 36.5(19) Chest pain, %(n) 13.5(7) Palpitations, %(n) 15.3(8) Dizziness, %(n) 3.8(2) Weakness, %(n 1.9(1) Cyanosis, %(n) 1.9(1) Pharmacotherapy, %(n) 50（26） Propaphenone, %(n) 17.3(9) Metoprolol, %(n) 23.1(12) Sotalol, %(n) 1.9(1) Digoxin, %(n) 3.8(2) Triphosadenine(ATP), %(n) 7.7(4) BSA—body surface area, PVCs—premature ventricular contractions, PACs—premature atrial contractions, PSVT—Paroxysmal superventricular tachycardia Children with PVCs were significantly more likely to undergo CMR than those with PACs and PSVT. The average burden of PVC or PAC is 12.4%. Only one child with PSVT experienced two episodes of supravicular tachycardia on 24-h Holter ECG-monitoring. They were hospitalized because of ECG findings of PSVT and improved CMR for repeated supravicular tachycardia attacks. A total of 36.5% of the children were symptomatic, and the most common symptom was palpitation, followed by chest pain and dizziness. One of the children living at high altitude presented cyanosis and was cured after oxygen treatment. One half of the children (with severe or symptomatic arrhythmias) received pharmacological treatment, propaphenone and metoprolol were the most commonly used antiarrhythmic drugs. A small number of children were treated with digoxin and sotalol. All the children with PSVT were treated with ATP pellet injection after the vagus stimulation failed, and 2 of them were given metoprolol to prevent ventricular tachycardia. No arrhythmic syncope or sudden cardiac death was recorded in our study. 3.2 CMR Findings The cardiac magnetic resonance results are shown in Table 2. The mean EF of all the children was normal. However, we found that 30.8% of the children had LGE, and all the LGE sites were in the free wall of the left ventricle, except for multiple areas in 1 patient. Four children were found to have perfusion disorders. There was enhanced perfusion in 2 children and decreased perfusion in 2 children. Two children with enhanced perfusion showed no LGE. However, the 2 patients with decreased perfusion had LGE. This may indicate that LGE is closely related to myocardial ischemia. Pericardial effusion was found in 51.9% of the children but the pericardial effusion was small in all patients. Table 2.CMR Findings of all chlidren. Index Study Group n = 52 LV SV(ml) 37.38±18.48 LV EDVi(mL/m2) 66.68±12.57 LV ESVi(mL/m2) 29.39±8.64 LV SVi(mL/m2) 36.71±8.40 LV mass(g/m2) 46.12±9.15 LV EF(%) 55.39±6.81 CO(L/min) 2.85±1.22 CI(L/min/m2) 2.91±0.81 LV Peak Ejection Rate(ml/s/m2) 225.85±57.98 LV Peak Filling Rate(ml/s/m2) 192.19±59.93 LGE %(n) 30.8(16) perfusion disorders %(n) 7.7(4) pericardial effusion %(n) 51.9(27) LV—left ventricle; LV EDV—Left ventricle end-diastolic volume; LV ESV—Left ventricle end-systolic volume; LV SV—Left ventricle stroke volume; CO—cardiac output; CI—cardiac index; LV EF—Left ventricle ejection fraction; LGE—late gadolinium enhancement. 3.3 PVC and PAC contrast 3.3.1Comparison of patient characteristics according to PVC and PAC qualifications for CMR is presented in Table 3. There were no significant differences in gender, age, body surface area or arrhythmia burden between the two groups. In terms of symptoms, the PACs were significantly more common than PVCs, especially with respect to chest pain and palpitations. One patient’s symptom was cyanosis, probably because he lived in a high-altitude area. With respect to pharmacotherapy, there was no significant difference between the two groups. But in the choice of anti-arrhythmia agent, propaphenone was used more frequently in PVCs and metoprolol was used more frequently in PACs. Only 1 patient with PACs received sotalol and digoxin. Table 3. Patients’ baseline characteristics of PVC and PAC. Feature PVC n = 37 PAC n = 11 χ 2/Z/t p Mean age, (years, mean ± SD) 7.83±3.76 8.18±4.29 -0.26 0.79 Male sex, %(n) 59.5(22) 63.6(7) 1.0 0.55 BSA(m 2 ) 1.0±0.38 1.04±0.40 -0.31 0.76 PVC/PACs number (mean ± SD) 17750±11984 14576±15726 0.71 0.48 PVC/PACs % (mean ± SD) 12.70±7.81 11.50±11.30 0.40 0.70 Symptoms, %(n) 24.32(9) 63.6(7) 0.07 0.07 Chest pain, %(n) 8.1(3) 27.3(3) 0.12 0.12 Palpitations, %(n) 10.8(4) 18.2(2) 0.61 0.42 Dizziness, %(n) 2.7(1) 9.1 (1) 0.87 0.35 Cyanosis, %(n) 0 9.1 (1) - - Pharmacotherapy, %(n) 43.2(16) 54.5(6) 0.73 0.38 Propaphenone, %(n) 21.6(8) 9.1(1) 0.66 0.33 Metoprolol, %(n) 18.9(7) 27.3(3) 0.68 0.41 Digoxin, %(n) 0 9.1(1) - - Sotalol, %(n) 0 9.1(1) - - BSA—body surface area, PVCs—premature ventricular contractions, PACs—premature atrial contractions, 3.3.2 The contrast of the CMR Findings for the PVC and PAC are shown in Table 4. There were no significant differences in the LV SV, LAD, RAD, LV EDD, RV EDD, LV mass, CO, CI, LV peak ejection and filling rate between the two groups. The LV ESVi of the PVCs was significantly greater than that of the PACs ( p<0.05 ). But the LV EF, LV EDVi and CO did not significant differ between the two groups. There were no significant differences in LGE, perfusion disorders or pericardial effusion between the two groups. Table 4.CMR Findings of PVC and PAC. PVC n = 37 PAC n = 11 χ 2/Z/t p LV SV(ml) 36.86±18.86 37.87±17.55 -0.16 0.88 LAD（mm） 22.96±4.60 27.27±12.88 -1.09 0.30 RAD（mm） 34.44±4.69 36.18±11.92 -0.73 0.47 LV EDD（mm） 39.14±5.03 37.64±6.15 0.83 0.41 RV EDD（mm） 34.11±5.15 34.27±6.19 -0.09 0.93 LV EDVi(mL/m2) 68.38±12.13 60.70±14.65 1.69 0.09 LV ESVi(mL/m2) 31.25±8.08 23.43±9.64 2.70 0.01 LV SVi(mL/m2) 37.45±7.03 33.80±12.27 0.94 0.36 LV mass(g/m2) 46.57±8.62 44.39±12.38 0.67 0.51 LV EF(%) 54.26±5.93 58.80±8.98 -1.58 0.14 CO(L/min) 2.84±1.31 2.78±0.93 0.15 0.89 CI(L/min/m2) 2.91±0.85 2.88±0.83 0.09 0.96 LV Peak Ejection Rate(ml/s/m2) 224.24±60.69 232.81±60.49 0.41 0.68 LV Peak Filling Rate(ml/s/m2) 194.95±59.77 180.43±57.22 0.65 0.52 LGE %(n) 32.4(12) 36.4(4) 1.0 0.54 perfusion disorders %(n) 8.1(3) 9.1(1) 1.0 0.66 pericardial effusion %(n) 51.4(19) 45.4(5) 1.0 0.50 LV—left ventricle ; LAD —left atrium diameter; RAD—right atrium diameter; LV EDD—left ventricular end－diastolic diameter; RV EDD—right ventricular end－diastolic diameter; LV EDV—Left ventricle end-diastolic volume, LV ESV—Left ventricle end-systolic volume, LV SV—Left ventricle stroke volume, CO—cardiac output, CI—cardiac index, LV EF—Left ventricle ejection fraction, LGE—late gadolinium enhancement. 3.3.3 Clinical characteristics and other CMR indices of patients with LGE are shown in Table 5. Table 5. Clinical characteristics and other CMR index of patients in relation to LGE(except PSVT). Features Children with LGE n=16 Children without LGE n=32 χ 2/Z/t p Mean age, (years, mean ± SD) 6.89±3.28 8.42±4.05 1.57 0.13 Male sex, %(n) 62.5(10) 59.4(19) 0.56 0.37 BSA(m 2 ) 0.91±0.35 1.05±0.40 1.22 0.23 Symptoms, %(n) 37.5(6) 34.4(11) 0.75 0.43 Pharmacotherapy, %(n) 62.5(10) 50.0(16) 0.37 0.18 24-h Holter ECG-monitoring PVC/PACs number (mean ± SD) 22913±17134 14238±9343 -2.17 0.04 PVC/PACs % (mean ± SD) 15.69±11.14 10.80±6.64 -1.62 0.12 Bigeminy number (mean ± SD) 812±1657 373±960 -1.01 0.33 CMR index LV SV(ml) 30.53±11.73 40.38±20.32 2.22 0.03 LAD（mm） 24.68±11.40 23.52±4.39 -0.39 0.69 RAD（mm） 34.56±9.99 35.01±4.98 0.22 0.83 LV EDD（mm） 37.68±3.11 39.33±5.94 1.05 0.30 RV EDD（mm） 32.50±3.98 34.83±5.65 1.49 0.14 LV EDVi(mL/m2) 65.48±11.60 67.29±13.74 0.45 0.65 LV ESVi(mL/m2) 30.12±7.42 29.13±9.78 -0.40 0.69 LV SVi(mL/m2) 35.36±8.04 37.24±8.78 0.77 0.45 LV mass(g/m2) 45.04±8.68 46.59±9.98 0.56 0.58 LV EF(%) 52.03±5.34 56.93±7.10 2.48 0.016 CO(L/min) 2.34±0.66 3.07±1.36 2.65 0.011 CI(L/min/m2) 2.70±0.71 3.00±0.89 1.23 0.23 LV Peak Ejection Rate(ml/s/m2) 188.90±51.75 243.75±56.20 3.19 0.002 LV Peak Filling Rate(ml/s/m2) 170.87±40.54 203.82±64.83 2.01 0.05 Perfusion disorders %(n) 18.75(3) 3.1(1) 3.98 0.46 Pericardial effusion %(n) 81.3(13) 43.8(14) 0.007 0.005 LGE—late gadolinium enhancement, BSA—body surface area, PVCs—premature ventricular contractions, PACs—premature atrial contractions, LV—left ventricle; LAD —left atrium diameter; RAD—right atrium diameter; LV EDD—left ventricular end－diastolic diameter; RV EDD—right ventricular end－diastolic diameter; LV EDV—Left ventricle end-diastolic volume, LV ESV—Left ventricle end-systolic volume, LV SV—Left ventricle stroke volume, CO—cardiac output, CI—cardiac index, LV EF—Left ventricle ejection fraction. In this table, we ruled out the PSVT because of its small sample size and the 24-hour Holter, ECG revealed fewer supravicular tachycardia episodes. We didn’t classify the PVC and PAC groups because of the small sample size. There were no obvious differences in age, sex, body surface area, symptoms or medication. For the 24-hour Holter ECG results, the LGE group has significantly greater absolute value{22913±17134 vs. 14238±9343} of arrhythmias( p<0.05 ) than did the non-LGE group. The LGE group had a greater number of patients with bigeminy than did the non-LGE group. LV SV{30.53±11.73 vs. 40.38±20.32}, LV EF{52.03±5.34 vs. 56.93±7.10} and CO{2.34±0.66 vs. 3.07±1.36} in the LGE group was significantly lower than those in the non-LGE group ( p<0.05 ), as shown in Figure 1. The LV Peak Ejection Rate in the non-LGE group was obviously greater than that in the LGE group( p<0.05 ). The AUCs of the SV, EF, PVC/PAC number, and CO were 0.62 (95% CI: 0.45–0.78), 0.71 (95% CI: 0.56–0.85), 0.70 (95% CI: 0.55–0.85), and 0.62 (95% CI: 0.46–0.78), respectively, The AUCs are shown in Figure 2. There was no significant different in perfusion disorders between the two groups. But more children in the LGE group had pericardial effusion( p<0.05 ). 3.3.4 The findings of PSVT group There were only 4 children in PSVT group and they were all girls with average age of 9.67years. Half of them had the symptom of palpitation. Only one child had seen second supracentric attack. And both of them didn’t find LGE and perfusion disorders in CMR, but 3 of them had pericardial effusion. As for the cardiac function index, only 1 of them had a slight decrease in ejection fraction. 3.3.5 Comparison of cardiac function indexes with CMR reference values We matched our measured cardiac function indicators with the multicenter reference values of European6 according to age and gender, and conducted statistical analysis, the results were shown in Table 6. Table 6 cardiac function indicators with the multicenter reference values LV SV(ml) LV EDVi(mL/m2) LV ESVi(mL/m2) LV SVi(mL/m2) LV mass(g/m2) LV EF(%) Study Group n = 52 37.38±18.49 66.68±12.57 29.39±8.64 36.71±8.40 46.12±9.15 55.39±6.81 reference values n = 52 48.17±25.15 65.44±12.21 20.85±4.41 43.54±7.39 48.98±8.91 67.27±3.23 (t, p ) -4.58/0.00 0.61/ 0.54 6.99/0.00 -5.13/0.00 -1.93/0.06 10.96/0.00 PVC n = 37 36.86±18.86 68.38±12.13 31.25±8.08 37.45±7.03 46.57±8.62 54.26±5.93 reference values n = 37 47.70±24.29 65.48±11.85 20.62±4.49 43.73±7.15 48.59±8.39 67.76±3.28 (t, p ) -3.98/0.00 1.24/0.22 7.42/0.00 -4.29/0.00 -1.12/0.27 11.51/0.00 PAC n = 11 37.87±17.55 60.99±14.65 23.43±9.64 33.79±12.26 44.39±12.38 58.80±8.98 reference values n = 11 50.18±30.44 66.45±14.86 21.45±4.80 43.73±8.93 51.27±11.56 66.55±3.17 (t, p ) -1.9/0.08 -1.11/0.29 0.87/0.40 -2.68/0.02 -2.09/0.06 -2.79/0.02 PSVT n = 4 40.83±22.24 66.53±7.15 28.59±1.68 37.94±8.11 46.71±2.88 56.45±6.11 reference values n = 4 47.00±23.79 62.25±9.91 21.25±2.99 41.25±6.45 46.25±5.32 64.75±1.26 (t, p ) -1.45/0.24 1.11/0.35 5.00/0.02 -0.89/0.44 0.28/0.80 -2.85/0.07 LV SV—Left ventricle stroke volume, LV EDVi—Left ventricle end-diastolic volume/m 2 , LV ESVi—Left ventricle end-systolic volume/m 2 , LV SV—Left ventricle stroke volume/m 2 , LV EF—Left ventricle ejection fraction. From this table, we can find that the LV SV, LV Svi and LV EF of our study group are significantly lower than reference values(p<0.05). The LV ESVi of our group is higher than reference(p<0.05). And the LV EDVi is also higher than reference. On the contrary the LV mass of our group is lower than reference, also it’s not yet statistically significant. The same results were found in the PVC group. However, in PAC group, the LV EDVi is lower than reference which is different from others but the LV Svi and LE EF are also lower than reference. The PSVTgroup has same trend with PVC group, but it lacks of statistical value because the sample size is too small. 4. Discussion PVC, PAC and PSVT are common tachyarrhythmias in children, they often have unclear causes and can disappear spontaneously, so the prognosis is good. However, chronic and frequent tachyarrhythmia can lead to decreased ventricular function and ventricular dilation. Studies have shown that 7% PVC can lead to dilated cardiomyopathy( 9 ). Jonathan W reported that the specificity for congestive heart failure prediction exceeded 90% when PVCs comprised at least 0.7% of total ventricular beats( 10 ). However, in children the most common types of arrhythmias that cause tachycardia-induced cardiomyopathy are atrial tachycardia and permanent junctional reciprocating tachycardia( 11 ). Therefore, the inclusion criterion of our study was greater than 1% and all PSVT children. Frequently, arrhythmias affect normal heart function. Therefore, for children with obvious symptoms, heavy arrhythmia burdens and repeated attacks, examination should be performed to identify the etiology and assess cardiac function provide timely and correct treatment measures. Arrhythmias in children can be divided into functional and organic. Functional arrhythmias which usually have a good prognosis, indicate no organic heart disease, no electrolyte disorders, no hemodynamic disorders, and no symptoms or mild symptoms. Organic arrhythmia is mostly related to basic heart disease, myocarditis and cardiomyopathy. CMR has the advantages of multi-sequence, multi-parameter and multi-plane scanning, which can be used to quantitatively or qualitatively analyze the characteristics of myocardial tissue( 12 ) to noninvasively evaluate the pathological changes in inflammation and cardiac function of the myocardium. In addition to tissue characterization, CMR is the gold standard for the quantification of ventricular volum, ejection fraction, and mass( 13 ). The 2009 Journal of the American College of Cardiology had released the Lake Louise criteria for the CMR diagnosis of myocarditis and introduced the mapping of quantitative parameters in 2018( 14 ). The 2021 American Heart Association Statement on the Diagnosis and Management of Myocarditis in Children noted the important value of CMR. This emphasized the role of T2-weighted imaging and LGE becausethey can react to myocardial edema and necrosis( 13 ). However, there is a lack of CMR Date concerning cardiac function in children. A European multicenter study enrolled 141 healthy children aged 0–18 years who underwent CMR derived ventricular size and function data ( 15 ). Therefore, we used these data as a reference standard to evaluate the effect of arrhythmia on cardiac function. In this way, we find that when matched by age and sex, the LV SV, LV Svi and LV EF of our study group are significantly lower than the reference values, and the LV ESVi and the LV EDVi are higher than the reference values. This finding proves that the LV SV, LV Svi and LV EF are decreased in children with tachyarrhythmia to a certain extent. LGE is considered an indicator of myocardial fibrosis( 16 ), and the extent of LGE is an independent predictor of adverse events in children with idiopathic hypertrophic cardiomyopathy( 17 ). In our study, children with LGE had greater arrhythmia burdens and absolute values, which is similar to the findings of Halszka Kaminska’s study( 4 ). This is not difficult to understand, the greater the arrhythmia burden is and the longer the duration is, the greater the degree of damage to the heart. Furthermore, cardiac fibrosis leading to conduction block or delay is one of the causes of arrhythmia( 1 ). Therefore, LGE is an important marker of arrhythmia in children. Follow-up studies on the changes in LGE can be used to evaluate the treatment effect in children with arrhythmia. We found that the LV SV, LV EF and CO in the LGE group were significantly lower than those in the non-LGE group. The AUCs of EF and the PVC/PAC rate were 0.71 and 0.70, respectively. The AUC of SV and CO was 0.62. These findings suggest that the LV EF, SV, and CO can reflect the LGE of the myocardium to a certain extent. This is a revelation for clinicians: When cardiac function decreases or when children have a high arrhythmia burden in practice, cardiac MRI should be actively performed to understand whether there is myocardial damage to facilitate active treatment and avoid sequelae. Previous studies have shown that LGE is a marker of nonischemic cardiac tissue. However, in our study, 2 children with enhanced perfusion had no LGE but 2 children with decreased perfusion were all manifested had LGE. These findings suggest that LGE is also associated with myocardial ischemia which need more large sample studies to confirm. And all the LGE sites were in the free wall of the left ventricle in our study. It is distributed mainly in the apical segment and subepicardial region. The shape is spot-like, linear and lamellar. This is different from the findings of Cinzia Crescenzi 's study, which focused on the athletes with apparently idiopathic VA( 18 ). This shows that there are clear differences between adults and children. Compared with echocardiography, CMR allows for improved reliability in the measurement of maximum wall thickness, identification of the pattern of LV hypertrophy, and estimation of LV mass, compared to echocardiography( 7 ). The studies of Jonathan D Windram( 19 ) and Yan Chao focused on pediatric patients with hypertrophic cardiomyopathy have demonstrated greater LV mass in patients with LGE( 20 ). But in our study, the LV mass was not significantly different between the LGE group and the non-LGE group. This is likely because our study excluded children with cardiomyopathy, and the presence of an LV mass is characteristic of hypertrophic cardiomyopathy. A total of 52 children were included in this study, including 11 with PAC, 37 with PVC, and only 4 with PSVT. A large population-based study of children revealed that the morbidity of PAC was lower than that of PVC( 21 ). In addition, in clinical practice, doctors pay more attention to nonsupracentricular arrhythmias because they are more dangerous, so more children with PVCs are hospitalized and finish CMR than PVC and PSVT. And CMR may not be performed in children with no symptoms or a low PAC burden, so the proportion of patients with symptoms and pharmacotherapy in the PAC group were greater than that in the PVC group. In our study, the LV Svi and LV EF in the PAC group were lower than those in the reference group. When the arrhythmia burden was similar, the LV Svi in the PAC group was lower than that in the PAC group, and the LGE, perfusion disorders and pericardial effusion were similar between the PAC group and the PVC group, which indicates that the PAC also affects cardiac pumping function. Hung-Yu Liu et al. found PACs were associated with infarcts of multiple vascular territories and poor function in stroke patients( 22 ). Can Hasdemir et al. found that PACs can induce myocardiopathy( 23 ). Leeper et al. found that Frequent PACs was independent predictors of atrial fibrillation( 24 ). These findings suggest that clinicians should pay more attention to the treatment of PAC. There are several limitations in this study. First, our sample size is small. The echocardiography parameters were not included, and we didn’t measure right ventricular function. In addition, with the development of CMR technology, the value of using the cardiac magnetic resonance tissue tracking technique(CMR-TT) to evaluate myocardial strain and locate it to damaged myocardial segments is greater than that of LVEF in adult patient( 25 ). This will be the target of our next research. 5.Conclusions LV SV, LV Svi and LV EF are significantly decrease in children with tachyarrhythmia. PAC also affects cardiac pumping function, and clinicians should pay more attention to the treatment of PAC. Children who have a high arrhythmia burden or cardiac function decline should be actively undergo CMR. CMR provides valuable clinical information in many cases of arrhythmia in children, mainly because of its advanced ability to characterize tissue and assess the heart function. Large sample studies are needed for further confirmation. CMRs need to be performed in large populations of children to establish normal reference standards. Abbreviations CMR Cardiac magnetic resonance CO cardiac output CI cardiac index LV EDV Left ventricle end-diastolic volume LV EDVi Left ventricle end-diastolic volume/m2 LV ESV Left ventricle end-systolic volume LV ESVi Left ventricle end-systolic volume/m2 LV EF Left ventricle ejection fraction LV SV Left ventricle stroke volume LGE late gadolinium enhancement PVC premature ventricular contraction PAC premature atrial contraction Declarations Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflicts of interest. Author contributions Y-FY contributed to the collection of clinical data, the analysis and interpretation of the data, and the drafting and final approval of the manuscript. LG contributed to the collection of clinical data, the analysis and interpretation of the data, and drafting of the manuscript. BY and XY contributed to the collection of clinical data and the analysis of the data. Y-HG and Y-ZW contributed to the collection of clinical data. KS supervised the project, contributed to the conception and design of the study, to the analysis and interpretation of the data, and to the critical revision and final approval of the manuscript. All authors made substantial contributions to the study and manuscript. Funding This research was supported by the Health Commission of Chengdu Municipality (2021162). Acknowledgments We thank the Chengdu Municipal Health Commission (2021162) for their support. References Jat KR, Lodha R, Kabra SK. Arrhythmias in Children. Indian J Pediatr (2011) 78:211–218. Ferreira VM, Schulz-Menger J, Holmvang G, Kramer CM, Carbone I, Sechtem U, Kindermann I, Gutberlet M, Cooper LT, Liu P, et al. Cardiovascular Magnetic Resonance in Nonischemic Myocardial Inflammation: Expert Recommendations. J Am Coll Cardiol (2018) 72:3158–3176. Kirmani S, Woodard PK, Shi L, Hamza TH, Canter CE, Colan SD, Pahl E, Towbin JA, Webber SA, Rossano JW, et al. Cardiac imaging and biomarkers for assessing myocardial fibrosis in children with hypertrophic cardiomyopathy. Am Heart J (2023) 264:153–162. Kamińska H, Małek ŁA, Barczuk-Falęcka M, Bartoszek M, Strzałkowska-Kominiak E, Marszałek M, Brzezik E, Brzewski M, Werner B. The Role of Cardiac Magnetic Resonance in Evaluation of Idiopathic Ventricular Arrhythmia in Children. J Clin Med (2021) 10:1335. Banerji D, Mendoza D, Ghoshhajra BB, Hedgire SS. The Role of Contrast-Enhanced Cardiac Magnetic Resonance in the Assessment of Patients with Malignant Ventricular Arrhythmias. Magn Reson Imaging Clin N Am (2019) 27:475–490. Banka P, Geva T. Advances in pediatric cardiac MRI. Curr Opin Pediatr (2016) 28:575–583. Spinner JA, Noel CV, Denfield SW, Krishnamurthy R, Jeewa A, Dreyer WJ, Maskatia SA. Association of Late Gadolinium Enhancement and Degree of Left Ventricular Hypertrophy Assessed on Cardiac Magnetic Resonance Imaging With Ventricular Tachycardia in Children With Hypertrophic Cardiomyopathy. Am J Cardiol (2016) 117:1342–1348. Chang Y, Dong M, Fan L, Kang B, Sun W, Li X, Yang Z, Ren M. Research on noninvasive electrophysiologic imaging based on cardiac electrophysiology simulation and deep learning methods for the inverse problem. BMC Cardiovasc Disord (2025) 25:335. Krynski T, Stec S, Szmit S, et al. Impact of radiofrequency catheter ablation on echocardiographic and cardiopulmonary performance in patients with ventricular extrasystolic beats and suspected arrhythmia-induced cardiomyopathy. Heart Vessels. 2014;29(6):808-816. Dukes JW, Dewland TA, Vittinghoff E, Mandyam MC, Heckbert SR, Siscovick DS, Stein PK, Psaty BM, Sotoodehnia N, Gottdiener JS, et al. Ventricular Ectopy as a Predictor of Heart Failure and Death. J Am Coll Cardiol (2015) 66:101–109. Aykan HH, Karagöz T, Akın A, İrdem A, Özer S, Çeliker A. Results of radiofrequency ablation in children with tachycardia-induced cardiomyopathy. Anadolu Kardiyol Derg. 2014;14(7):625-630. Messroghli DR, Moon JC, Ferreira VM, et al. Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: A consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson. 2017;19(1):75. Law YM, Lal AK, Chen S, Čiháková D, Cooper LT, Deshpande S, Godown J, Grosse-Wortmann L, Robinson JD, Towbin JA, et al. Diagnosis and Management of Myocarditis in Children: A Scientific Statement From the American Heart Association. Circulation (2021) 144:e123–e135. Friedrich MG, Sechtem U, Schulz-Menger J, Holmvang G, Alakija P, Cooper LT, White JA, Abdel-Aty H, Gutberlet M, Prasad S, et al. Cardiovascular magnetic resonance in myocarditis: A JACC White Paper. J Am Coll Cardiol (2009) 53:1475–1487. Van Der Ven JPG, Sadighy Z, Valsangiacomo Buechel ER, Sarikouch S, Robbers-Visser D, Kellenberger CJ, Kaiser T, Beerbaum P, Boersma E, Helbing WA. Multicentre reference values for cardiac magnetic resonance imaging derived ventricular size and function for children aged 0–18 years. Eur Heart J - Cardiovasc Imaging (2020) 21:102–113. Gräni C. How cardiac magnetic resonance is changing the management of myocarditis. Eur Heart J (2023) 44:909–911. Nucifora G, Selvanayagam JB. Cardiac Magnetic Resonance Late Gadolinium Enhancement Imaging in Arrhythmic Risk Stratification. Heart Lung Circ (2020) 29:1268–1269. Crescenzi C, Zorzi A, Vessella T, Martino A, Panattoni G, Cipriani A, De Lazzari M, Perazzolo Marra M, Fusco A, Sciarra L, et al. Predictors of Left Ventricular Scar Using Cardiac Magnetic Resonance in Athletes With Apparently Idiopathic Ventricular Arrhythmias. J Am Heart Assoc (2021) 10:e018206. Windram JD, Benson LN, Dragelescu A, Yoo S-J, Mertens L, Wong D, Grosse-Wortmann L. Distribution of Hypertrophy and Late Gadolinium Enhancement in Children and Adolescents with Hypertrophic Cardiomyopathy. Congenit Heart Dis (2015) 10:E258-267. Chaowu Y, Shihua Z, Jian L, Li L, Wei F. Cardiovascular magnetic resonance characteristics in children with hypertrophic cardiomyopathy. Circ Heart Fail (2013) 6:1013–1020. Niwa K, Warita N, Sunami Y, Shimura A, Tateno S, Sugita K. Prevalence of arrhythmias and conduction disturbances in large population-based samples of children. Cardiol Young (2004) 14:68–74. Liu HY, Wu JY, Chung CP, et al. Premature Atrial Contractions and Their Association with Stroke Features and Outcome. J Stroke Cerebrovasc Dis. 2020;29(10):105118. Hasdemir C, Kocabas U, Kilic S, Kose S, Kilic S, Gunduz R, Ulucan C, Yagmur B, Sahin H, Celen C, et al. Premature Atrial Contraction-Induced Cardiomyopathy: Recognition of a Distinct Phenotype of Arrhythmia-Induced Cardiomyopathy in Humans. Am J Cardiol (2023) 197:65–67. eeper BB. Are Premature Atrial Contractions Benign?. AACN Adv Crit Care. 2023;34(3):263-265. Weise Valdés E, Barth P, Piran M, Laser KT, Burchert W, Körperich H. Left-Ventricular Reference Myocardial Strain Assessed by Cardiovascular Magnetic Resonance Feature Tracking and fSENC—Impact of Temporal Resolution and Cardiac Muscle Mass. Front Cardiovasc Med (2021) 8:764496. Additional Declarations No competing interests reported. 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1","display":"","copyAsset":false,"role":"figure","size":197142,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7326756/v1/73b88ae72a1143b232c81afd.png"},{"id":91829699,"identity":"9a8e0a9d-eaa8-467f-ac24-7a3a63ffb4e6","added_by":"auto","created_at":"2025-09-22 08:56:43","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":232600,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7326756/v1/62e97b63e67182ad801253da.png"},{"id":91830553,"identity":"174346ae-774e-4642-9633-f905d2e8cb65","added_by":"auto","created_at":"2025-09-22 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Introduction","content":"\u003cp\u003eIn recent years, pediatric arrhythmias have emerged as a distinct clinical domain within childhood cardiovascular medicine. These rhythm disturbances are categorized hemodynamically according to their hemodynamic effects into tachyarrhythmias and bradyarrhythmias(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Tachyarrhythmias include premature supraventricular beats (PSVBs) and premature ventricular contractions (PVCs). PSVBs originate from atrial tissue or the atrioventricular (AV) junction, and these ectopic beats are predominantly idiopathic and asymptomatic in pediatric populations(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Additionally, premature ventricular contractions are usually idiopathic and not associated with symptoms. However, when documented, underlying cardiac disease or more complex arrhythmias must be excluded. Doppler echocardiography and myocardial injury markers are widely used in the diagnostic evaluation of arrhythmia. However, since children with arrhythmias often lack apparent cardiovascular pathology, significant research has focused on uncovering their underlying, potentially dangerous causes.\u003c/p\u003e\u003cp\u003eCardiac magnetic resonance (CMR) imaging is an advanced, multifaceted, noninvasive imaging method that accurately assesses cardiac muscle structure and function. It has a good ability to locate the source of abnormal discharge and guide electrophysiological treatment. CMR has high spatial resolution and allows for clear scar delineation and quantification, which has prognostic value in the determination of arrhythmias(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Additionally, CMR provides more accurate detection of the left ventricular ejection fraction (LVEF) than does compared with transthoracic echocardiography as it is not limited by poor acoustic windows(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). The Late Gadolinium enhancement (LGE) has excellent histological correlation, so it is a powerful tool for assessing the presence of scars(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). The distribution of LGE assists in the determination of the various causes of cardiomyopathies, and serves as a prognostic marker for sudden cardiac death in adults(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). T2-weighted imaging for the assessment of myocardial edema is used to assess myocarditis(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Smith et al. reports that hypertrophic cardiomyopathy patients with ventricular tachycardia had more LV myocardial segments with LGE than patients without Ventricular Tachycardia. Joseph A et al. reported that compared with patients without ventricular tachycardia, patients with hypertrophic Cardiomyopathy with ventricular tachycardia have a greater LV mass index, more hypertrophied segments and greater maximum septal thickness(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Researchers at Xi'an Jiaotong University implemented a three-dimensional bidomain cardiac model combined with deep learning algorithms (e.g., long short-term memory, LSTM) to achieve inverse mapping from body surface potentials to myocardial electrical activity. Their simulated data demonstrated an 84.61% correlation with clinical CMR findings, providing critical evidence for preprocedural ablation pathway planning(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eResearch has demonstrated significant differences in CMR findings in hypertrophic cardiomyopathy children with ventricular arrhythmia. In our study, we explored CMR findings in children with tachyarrhythmia, to identify the potential etiology of children with tachyarrhythmia, and evaluate the cardiac function of these children, providing a reference for the treatment of children with arrhythmia.\u003c/p\u003e"},{"header":"2. Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Patients and methods\u003c/h2\u003e\u003cp\u003eChildren with tachyarrhythmia (including premature atrial contractions, paroxysmal superventricular tachycardia and premature ventricular contractions) at the Chengdu Women's and Children's Central Hospital from July 2022 to October 2023 were included. Our research was approved by the Ethics Committee of the Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China. All the children enrolled in this trial providesd informed consent forms signed by their parents or guardians.\u003c/p\u003e\u003cp\u003eAll the children underwent the ECG, 24-h Holter ECG-monitoring, and echocardiogram. The type of arrhythmia was assessed via ECG and quantified via 24-h Holter ECG-monitoring. All examinations were performed by experienced physicians, CMR imaging was performed via a Signa 3.0T, and all the images were obtained via a steady-state free precession (SSFP) pulse sequence. Images were obtained while the participants held their breath whenever possible. Young children unable to be properly instructed were sedated and images were obtained while they were breathing freely. All image postprocessing and data analysis was performed by two experienced radiologists. Visual semiquantitative scoring system for grading LGE patterns in cardiac magnetic resonance imaging. This study was approved by the Ethics Committee of the Chengdu Women's and Children's Central Hospital (NO.2021\u0026thinsp;\u0026minus;\u0026thinsp;118) and all patients enrolled in this trial had informed consent forms signed by their parents or guardians. This study was conducted in compliance with the ethical principles outlined in the Ethical Review Measures for Biomedical Research Involving Human Subjects (2016) issued by the National Health and Family Planning Commission of the People's Republic of China and the Declaration of Helsinki, as well as relevant Chinese laws and regulations.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Inclusion and exclusion criteria\u003c/h2\u003e\u003cp\u003eChildren who were diagnosed with tachyarrhythmia via Holter monitoring and who underwent examination and cardiac function analysis at the time of initial diagnosis were enrolled in our study. Those who met the following criteria were excluded: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) ultrasonic cardiogram or Cardiovascular CT revealed structural heart disease; (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) the child had been diagnosed with cardiomyopathy, abnormal coronary origin, hypertension or other diseases or a family history of sudden death; (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)24-h Holter monitoring revealed that the PVC or PAC load was less than 1%; and (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) failure to complete cardiac magnetic resonance examination or poor image quality led to unreliable results.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Data collection\u003c/h2\u003e\u003cp\u003eThe relevant information, including baseline information, symptoms, ECG, 24-h Holter ECG-monitoring, echocardiogram and CMR results, included the left atrial diameter, ventricular end diastolic dimension, aortic root width, ejection fraction (EF), stroke volume (SV), stroke volume index (SVi), left ventricular mass (LVM), cardiac output (CO), cardiac index (CI), end-diastolic volume index (EDVi), end-systolic volume index (ESVi), peak ejection rate, peak filling rate, LGE and location, abnormal perfusion and location.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Data analysis\u003c/h2\u003e\u003cp\u003eAll the date were analyzed with SPSS statistical software (version 26; SPSS, Chicago, IL, USA). Normally distributed measurement data are presented as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;S.D, and Student\u0026rsquo;s t test was used to test the significance of the differences among the compared samples. Nonnormally distributed measurement data are presented as the median (IQR), and the Mann\u0026ndash;Whitney U test was used for the analyses. Count data were analyzed by means of the chi-square test. \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered significantly different. All figures were drawn with GraphPad Prism (version 8.0; GraphPad Software, Chicago, IL, USA).\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003e3.1 A summary of patient characteristics at the time of qualification for CMR is presented in Table 1.\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eTable 1. Baseline characteristics of all children.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eFeature\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003eStudy Group n = 52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eMean age, (years, mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e8.0\u0026plusmn;3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eMale sex, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e52.3(23)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eBSA(m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e1.0\u0026plusmn;0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003ePVCs, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e71.2(37)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003ePACs, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e21.2(11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003ePSVT, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e7.7(4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003ePVC/PACs number (mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e15673\u0026plusmn;13153\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003ePVC/PACs % (mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e12.4\u0026plusmn;8.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eSymptoms, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e36.5(19)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eChest pain, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e13.5(7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003ePalpitations, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e15.3(8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eDizziness, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e3.8(2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eWeakness, %(n\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e1.9(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eCyanosis, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e1.9(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003ePharmacotherapy, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e50（26）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003ePropaphenone, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e17.3(9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eMetoprolol, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e23.1(12)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eSotalol, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e1.9(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eDigoxin, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e3.8(2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eTriphosadenine(ATP), %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e7.7(4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 100px;\"\u003e\n \u003cp\u003eBSA\u0026mdash;body surface area, PVCs\u0026mdash;premature ventricular contractions, PACs\u0026mdash;premature atrial contractions, PSVT\u0026mdash;Paroxysmal superventricular tachycardia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eChildren with PVCs were significantly more likely to undergo CMR than those with PACs and PSVT. The average burden of PVC or PAC is 12.4%. Only one child with PSVT experienced two episodes of supravicular tachycardia on 24-h Holter ECG-monitoring. They were hospitalized because of ECG findings of PSVT and improved CMR for repeated supravicular tachycardia attacks. A total of 36.5% of the children were symptomatic, and the most common symptom was palpitation, followed by chest pain and dizziness. One of the children living at high altitude presented cyanosis and was cured after oxygen treatment. One half of the children (with severe or symptomatic arrhythmias) received pharmacological treatment, propaphenone and metoprolol were the most commonly used antiarrhythmic drugs. A small number of children were treated with digoxin and sotalol. All the children with PSVT were treated with ATP pellet injection after the vagus stimulation failed, and 2 of them were given metoprolol to prevent ventricular tachycardia. No arrhythmic syncope or sudden cardiac death was recorded in our study.\u003c/p\u003e\n\u003cp\u003e3.2 CMR Findings\u003c/p\u003e\n\u003cp\u003eThe cardiac magnetic resonance results are shown in Table 2. The mean EF of all the children was normal. However, we found that 30.8% of the children had LGE, and all the LGE sites were in the free wall of the left ventricle, except for multiple areas in 1 patient. Four children were found to have perfusion disorders. There was enhanced perfusion in 2 children and decreased perfusion in 2 children. Two children with enhanced perfusion showed no LGE. However, the 2 patients with decreased perfusion had LGE. This may indicate that LGE is closely related to myocardial ischemia. Pericardial effusion was found in 51.9% of the children but the pericardial effusion was small in all patients.\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eTable 2.CMR Findings of all chlidren.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eIndex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003eStudy Group n = 52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eLV SV(ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e37.38\u0026plusmn;18.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eLV EDVi(mL/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e66.68\u0026plusmn;12.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eLV ESVi(mL/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e29.39\u0026plusmn;8.64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eLV SVi(mL/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e36.71\u0026plusmn;8.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eLV mass(g/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e46.12\u0026plusmn;9.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eLV EF(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e55.39\u0026plusmn;6.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eCO(L/min)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e2.85\u0026plusmn;1.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eCI(L/min/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e2.91\u0026plusmn;0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eLV Peak Ejection Rate(ml/s/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e225.85\u0026plusmn;57.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eLV Peak Filling Rate(ml/s/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e192.19\u0026plusmn;59.93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eLGE %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e30.8(16)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003eperfusion disorders %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e7.7(4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003epericardial effusion %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e51.9(27)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 100px;\"\u003e\n \u003cp\u003eLV\u0026mdash;left ventricle; LV EDV\u0026mdash;Left ventricle end-diastolic volume; LV ESV\u0026mdash;Left ventricle end-systolic volume; LV SV\u0026mdash;Left ventricle stroke volume; CO\u0026mdash;cardiac output; CI\u0026mdash;cardiac index; LV EF\u0026mdash;Left ventricle ejection fraction; LGE\u0026mdash;late gadolinium enhancement.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e3.3 PVC and PAC contrast\u003c/p\u003e\n\u003cp\u003e3.3.1Comparison of patient characteristics according to PVC and PAC qualifications for CMR is presented in Table 3.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere were no significant differences in gender, age, body surface area or arrhythmia burden between the two groups. In terms of symptoms, the PACs were significantly more common than PVCs, especially with respect to chest pain and palpitations. One patient\u0026rsquo;s symptom was cyanosis, probably because he lived in a high-altitude area.\u003c/p\u003e\n\u003cp\u003eWith respect to pharmacotherapy, there was no significant difference between the two groups. But in the choice of anti-arrhythmia agent, propaphenone was used more frequently in PVCs and metoprolol was used more frequently in PACs. Only 1 patient with PACs received sotalol and digoxin.\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003e\n \u003cp\u003eTable 3. Patients\u0026rsquo; baseline characteristics of PVC and PAC.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFeature\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003ePVC n = 37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003ePAC n = 11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026chi; 2/Z/t\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMean age, (years, mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.83\u0026plusmn;3.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8.18\u0026plusmn;4.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMale sex, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e59.5(22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e63.6(7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eBSA(m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.0\u0026plusmn;0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.04\u0026plusmn;0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePVC/PACs number (mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e17750\u0026plusmn;11984\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e14576\u0026plusmn;15726\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePVC/PACs % (mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12.70\u0026plusmn;7.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11.50\u0026plusmn;11.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSymptoms, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e24.32(9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e63.6(7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eChest pain, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8.1(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e27.3(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePalpitations, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.8(4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e18.2(2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDizziness, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.7(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9.1 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCyanosis, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9.1 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePharmacotherapy, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e43.2(16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e54.5(6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePropaphenone, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e21.6(8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9.1(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMetoprolol, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e18.9(7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e27.3(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDigoxin, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9.1(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSotalol, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9.1(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003e\n \u003cp\u003eBSA\u0026mdash;body surface area, PVCs\u0026mdash;premature ventricular contractions, PACs\u0026mdash;premature atrial contractions,\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e3.3.2 The contrast of the CMR Findings for the PVC and PAC are shown in Table 4.\u003c/p\u003e\n\u003cp\u003eThere were no significant differences in the LV SV, LAD, RAD, LV EDD, RV EDD, LV mass, CO, CI, LV peak ejection and filling rate between the two groups. The LV ESVi of the PVCs was significantly greater than that of the PACs (\u003cem\u003ep\u0026lt;0.05\u003c/em\u003e). But the LV EF, LV EDVi and CO did not significant differ between the two groups. There were no significant differences in LGE, perfusion disorders or pericardial effusion between the two groups.\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003e\n \u003cp\u003eTable 4.CMR Findings of PVC and PAC.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003ePVC n = 37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003ePAC n = 11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026chi; 2/Z/t\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV SV(ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e36.86\u0026plusmn;18.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37.87\u0026plusmn;17.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLAD（mm）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e22.96\u0026plusmn;4.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e27.27\u0026plusmn;12.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eRAD（mm）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e34.44\u0026plusmn;4.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e36.18\u0026plusmn;11.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV EDD（mm）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e39.14\u0026plusmn;5.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37.64\u0026plusmn;6.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eRV EDD（mm）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e34.11\u0026plusmn;5.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e34.27\u0026plusmn;6.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV EDVi(mL/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e68.38\u0026plusmn;12.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e60.70\u0026plusmn;14.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV ESVi(mL/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e31.25\u0026plusmn;8.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e23.43\u0026plusmn;9.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV SVi(mL/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37.45\u0026plusmn;7.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e33.80\u0026plusmn;12.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV mass(g/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e46.57\u0026plusmn;8.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e44.39\u0026plusmn;12.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV EF(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e54.26\u0026plusmn;5.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e58.80\u0026plusmn;8.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCO(L/min)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.84\u0026plusmn;1.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.78\u0026plusmn;0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCI(L/min/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.91\u0026plusmn;0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.88\u0026plusmn;0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV Peak Ejection Rate(ml/s/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e224.24\u0026plusmn;60.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e232.81\u0026plusmn;60.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV Peak Filling Rate(ml/s/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e194.95\u0026plusmn;59.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e180.43\u0026plusmn;57.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLGE %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e32.4(12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e36.4(4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eperfusion disorders %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8.1(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9.1(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003epericardial effusion %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e51.4(19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e45.4(5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003e\n \u003cp\u003eLV\u0026mdash;left ventricle ; LAD \u0026mdash;left atrium diameter; RAD\u0026mdash;right atrium diameter; LV EDD\u0026mdash;left ventricular end－diastolic diameter; RV EDD\u0026mdash;right ventricular end－diastolic diameter; LV EDV\u0026mdash;Left ventricle end-diastolic volume, LV ESV\u0026mdash;Left ventricle end-systolic volume, LV SV\u0026mdash;Left ventricle stroke volume, CO\u0026mdash;cardiac output, CI\u0026mdash;cardiac index, LV EF\u0026mdash;Left ventricle ejection fraction, LGE\u0026mdash;late gadolinium enhancement.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e3.3.3 Clinical characteristics and other CMR indices of patients with LGE are shown in Table 5.\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003e\n \u003cp\u003eTable 5. Clinical characteristics and other CMR index of patients in relation to LGE(except PSVT).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFeatures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eChildren with LGE n=16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eChildren without LGE n=32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026chi; 2/Z/t\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMean age, (years, mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.89\u0026plusmn;3.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8.42\u0026plusmn;4.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMale sex, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e62.5(10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e59.4(19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eBSA(m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.91\u0026plusmn;0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.05\u0026plusmn;0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSymptoms, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37.5(6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e34.4(11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePharmacotherapy, %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e62.5(10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e50.0(16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e24-h Holter ECG-monitoring\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePVC/PACs number (mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e22913\u0026plusmn;17134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e14238\u0026plusmn;9343\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePVC/PACs % (mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e15.69\u0026plusmn;11.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.80\u0026plusmn;6.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eBigeminy number (mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e812\u0026plusmn;1657\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e373\u0026plusmn;960\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCMR index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV SV(ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e30.53\u0026plusmn;11.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e40.38\u0026plusmn;20.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLAD（mm）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e24.68\u0026plusmn;11.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e23.52\u0026plusmn;4.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eRAD（mm）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e34.56\u0026plusmn;9.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e35.01\u0026plusmn;4.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV EDD（mm）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37.68\u0026plusmn;3.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e39.33\u0026plusmn;5.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eRV EDD（mm）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e32.50\u0026plusmn;3.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e34.83\u0026plusmn;5.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV EDVi(mL/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e65.48\u0026plusmn;11.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e67.29\u0026plusmn;13.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV ESVi(mL/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e30.12\u0026plusmn;7.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e29.13\u0026plusmn;9.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV SVi(mL/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e35.36\u0026plusmn;8.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37.24\u0026plusmn;8.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV mass(g/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e45.04\u0026plusmn;8.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e46.59\u0026plusmn;9.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV EF(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e52.03\u0026plusmn;5.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e56.93\u0026plusmn;7.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCO(L/min)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.34\u0026plusmn;0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.07\u0026plusmn;1.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCI(L/min/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.70\u0026plusmn;0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.00\u0026plusmn;0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV Peak Ejection Rate(ml/s/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e188.90\u0026plusmn;51.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e243.75\u0026plusmn;56.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLV Peak Filling Rate(ml/s/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e170.87\u0026plusmn;40.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e203.82\u0026plusmn;64.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePerfusion disorders %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e18.75(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.1(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePericardial effusion %(n)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e81.3(13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e43.8(14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003e\n \u003cp\u003eLGE\u0026mdash;late gadolinium enhancement, BSA\u0026mdash;body surface area, PVCs\u0026mdash;premature ventricular contractions, PACs\u0026mdash;premature atrial contractions, LV\u0026mdash;left ventricle; LAD \u0026mdash;left atrium diameter; RAD\u0026mdash;right atrium diameter; LV EDD\u0026mdash;left ventricular end－diastolic diameter; RV EDD\u0026mdash;right ventricular end－diastolic diameter; LV EDV\u0026mdash;Left ventricle end-diastolic volume, LV ESV\u0026mdash;Left ventricle end-systolic volume, LV SV\u0026mdash;Left ventricle stroke volume, CO\u0026mdash;cardiac output, CI\u0026mdash;cardiac index, LV EF\u0026mdash;Left ventricle ejection fraction.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eIn this table, we ruled out the PSVT because of its small sample size and the 24-hour Holter, ECG revealed fewer supravicular tachycardia episodes. We didn\u0026rsquo;t classify the PVC and PAC groups because of the small sample size. There were no obvious differences in age, sex, body surface area, symptoms or medication. For the 24-hour Holter ECG results, the LGE group has significantly greater absolute value{22913\u0026plusmn;17134 vs. 14238\u0026plusmn;9343} of arrhythmias(\u003cem\u003ep\u0026lt;0.05\u003c/em\u003e) than did the non-LGE group. The LGE group had a greater number of patients with bigeminy than did the non-LGE group. LV SV{30.53\u0026plusmn;11.73 vs. 40.38\u0026plusmn;20.32}, LV EF{52.03\u0026plusmn;5.34 vs. 56.93\u0026plusmn;7.10} and CO{2.34\u0026plusmn;0.66 vs. 3.07\u0026plusmn;1.36} in the LGE group was significantly lower than those in the non-LGE group (\u003cem\u003ep\u0026lt;0.05\u003c/em\u003e),\u0026nbsp;as shown in Figure 1. The LV Peak Ejection Rate in the non-LGE group was obviously greater than that in the LGE group(\u003cem\u003ep\u0026lt;0.05\u003c/em\u003e). The AUCs of the SV, EF, PVC/PAC number, and CO were 0.62 (95% CI: 0.45\u0026ndash;0.78), 0.71 (95% CI: 0.56\u0026ndash;0.85), 0.70 (95% CI: 0.55\u0026ndash;0.85), and 0.62 (95% CI: 0.46\u0026ndash;0.78), respectively,\u0026nbsp;The AUCs are shown in Figure 2. There was no significant different in perfusion disorders between the two groups. But more children in the LGE group had pericardial effusion(\u003cem\u003ep\u0026lt;0.05\u003c/em\u003e).\u003c/p\u003e\n\u003cp\u003e3.3.4 The findings of PSVT group\u003c/p\u003e\n\u003cp\u003eThere were only 4 children in PSVT group and they were all girls with average age of 9.67years. Half of them had the symptom of palpitation. Only one child had seen second supracentric attack. And both of them didn\u0026rsquo;t find LGE and perfusion disorders in CMR, but 3 of them had pericardial effusion. As for the cardiac function index, only 1 of them had a slight decrease in ejection fraction.\u003c/p\u003e\n\u003cp\u003e3.3.5 Comparison of cardiac function indexes with CMR reference values\u003c/p\u003e\n\u003cp\u003eWe matched our measured cardiac function indicators with the multicenter reference values of European6 according to age and gender, and conducted statistical analysis, the results were shown in Table 6.\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 539px;\"\u003e\n \u003cp\u003eTable 6 cardiac function indicators with the multicenter reference values\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\u0026nbsp;\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eLV SV(ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eLV EDVi(mL/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eLV ESVi(mL/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eLV SVi(mL/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eLV mass(g/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eLV EF(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eStudy Group n = 52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37.38\u0026plusmn;18.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e66.68\u0026plusmn;12.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e29.39\u0026plusmn;8.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e36.71\u0026plusmn;8.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e46.12\u0026plusmn;9.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e55.39\u0026plusmn;6.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003ereference values n = 52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e48.17\u0026plusmn;25.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e65.44\u0026plusmn;12.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20.85\u0026plusmn;4.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e43.54\u0026plusmn;7.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e48.98\u0026plusmn;8.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e67.27\u0026plusmn;3.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e(t,\u003cem\u003ep\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-4.58/0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.61/ 0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6.99/0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-5.13/0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.93/0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10.96/0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003ePVC n = 37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e36.86\u0026plusmn;18.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e68.38\u0026plusmn;12.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e31.25\u0026plusmn;8.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37.45\u0026plusmn;7.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e46.57\u0026plusmn;8.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e54.26\u0026plusmn;5.93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003ereference values n = 37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e47.70\u0026plusmn;24.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e65.48\u0026plusmn;11.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20.62\u0026plusmn;4.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e43.73\u0026plusmn;7.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e48.59\u0026plusmn;8.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e67.76\u0026plusmn;3.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e(t,\u003cem\u003ep\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-3.98/0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.24/0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.42/0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-4.29/0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.12/0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11.51/0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003ePAC n = 11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37.87\u0026plusmn;17.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e60.99\u0026plusmn;14.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e23.43\u0026plusmn;9.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e33.79\u0026plusmn;12.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e44.39\u0026plusmn;12.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e58.80\u0026plusmn;8.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003ereference values n = 11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e50.18\u0026plusmn;30.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e66.45\u0026plusmn;14.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e21.45\u0026plusmn;4.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e43.73\u0026plusmn;8.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e51.27\u0026plusmn;11.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e66.55\u0026plusmn;3.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e(t,\u003cem\u003ep\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e-1.9/0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-1.11/0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.87/0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.68/0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.09/0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.79/0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePSVT n = 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e40.83\u0026plusmn;22.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e66.53\u0026plusmn;7.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e28.59\u0026plusmn;1.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37.94\u0026plusmn;8.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e46.71\u0026plusmn;2.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e56.45\u0026plusmn;6.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ereference values n = 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e47.00\u0026plusmn;23.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e62.25\u0026plusmn;9.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e21.25\u0026plusmn;2.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e41.25\u0026plusmn;6.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e46.25\u0026plusmn;5.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e64.75\u0026plusmn;1.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e(t,\u003cem\u003ep\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e-1.45/0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1.11/0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5.00/0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-0.89/0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.28/0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e-2.85/0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 539px;\"\u003e\n \u003cp\u003eLV SV\u0026mdash;Left ventricle stroke volume, LV EDVi\u0026mdash;Left ventricle end-diastolic volume/m\u003csup\u003e2\u003c/sup\u003e, LV ESVi\u0026mdash;Left ventricle end-systolic volume/m\u003csup\u003e2\u003c/sup\u003e, LV SV\u0026mdash;Left ventricle stroke volume/m\u003csup\u003e2\u003c/sup\u003e, LV EF\u0026mdash;Left ventricle ejection fraction.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eFrom this table, we can find that the LV SV, LV Svi and LV EF of our study group are significantly lower than reference values(p\u0026lt;0.05). The LV ESVi of our group is higher than reference(p\u0026lt;0.05). And the LV EDVi is also higher than reference. On the contrary the LV mass of our group is lower than reference, also it\u0026rsquo;s not yet statistically significant. The same results were found in the PVC group. However, in PAC group, the LV EDVi is lower than reference which is different from others but the LV Svi and LE EF are also lower than reference. The PSVTgroup has same trend with PVC group, but it lacks of statistical value because the sample size is too small.\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003ePVC, PAC and PSVT are common tachyarrhythmias in children, they often have unclear causes and can disappear spontaneously, so the prognosis is good. However, chronic and frequent tachyarrhythmia can lead to decreased ventricular function and ventricular dilation. Studies have shown that 7% PVC can lead to dilated cardiomyopathy(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Jonathan W reported that the specificity for congestive heart failure prediction exceeded 90% when PVCs comprised at least 0.7% of total ventricular beats(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). However, in children the most common types of arrhythmias that cause tachycardia-induced cardiomyopathy are atrial tachycardia and permanent junctional reciprocating tachycardia(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Therefore, the inclusion criterion of our study was greater than 1% and all PSVT children. Frequently, arrhythmias affect normal heart function. Therefore, for children with obvious symptoms, heavy arrhythmia burdens and repeated attacks, examination should be performed to identify the etiology and assess cardiac function provide timely and correct treatment measures. Arrhythmias in children can be divided into functional and organic. Functional arrhythmias which usually have a good prognosis, indicate no organic heart disease, no electrolyte disorders, no hemodynamic disorders, and no symptoms or mild symptoms. Organic arrhythmia is mostly related to basic heart disease, myocarditis and cardiomyopathy.\u003c/p\u003e\u003cp\u003eCMR has the advantages of multi-sequence, multi-parameter and multi-plane scanning, which can be used to quantitatively or qualitatively analyze the characteristics of myocardial tissue(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) to noninvasively evaluate the pathological changes in inflammation and cardiac function of the myocardium. In addition to tissue characterization, CMR is the gold standard for the quantification of ventricular volum, ejection fraction, and mass(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). The 2009 Journal of the American College of Cardiology had released the Lake Louise criteria for the CMR diagnosis of myocarditis and introduced the mapping of quantitative parameters in 2018(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The 2021 American Heart Association Statement on the Diagnosis and Management of Myocarditis in Children noted the important value of CMR. This emphasized the role of T2-weighted imaging and LGE becausethey can react to myocardial edema and necrosis(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). However, there is a lack of CMR Date concerning cardiac function in children. A European multicenter study enrolled 141 healthy children aged 0\u0026ndash;18 years who underwent CMR derived ventricular size and function data (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Therefore, we used these data as a reference standard to evaluate the effect of arrhythmia on cardiac function. In this way, we find that when matched by age and sex, the LV SV, LV Svi and LV EF of our study group are significantly lower than the reference values, and the LV ESVi and the LV EDVi are higher than the reference values. This finding proves that the LV SV, LV Svi and LV EF are decreased in children with tachyarrhythmia to a certain extent.\u003c/p\u003e\u003cp\u003eLGE is considered an indicator of myocardial fibrosis(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e), and the extent of LGE is an independent predictor of adverse events in children with idiopathic hypertrophic cardiomyopathy(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). In our study, children with LGE had greater arrhythmia burdens and absolute values, which is similar to the findings of Halszka Kaminska\u0026rsquo;s study(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). This is not difficult to understand, the greater the arrhythmia burden is and the longer the duration is, the greater the degree of damage to the heart. Furthermore, cardiac fibrosis leading to conduction block or delay is one of the causes of arrhythmia(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Therefore, LGE is an important marker of arrhythmia in children. Follow-up studies on the changes in LGE can be used to evaluate the treatment effect in children with arrhythmia.\u003c/p\u003e\u003cp\u003eWe found that the LV SV, LV EF and CO in the LGE group were significantly lower than those in the non-LGE group. The AUCs of EF and the PVC/PAC rate were 0.71 and 0.70, respectively. The AUC of SV and CO was 0.62. These findings suggest that the LV EF, SV, and CO can reflect the LGE of the myocardium to a certain extent. This is a revelation for clinicians: When cardiac function decreases or when children have a high arrhythmia burden in practice, cardiac MRI should be actively performed to understand whether there is myocardial damage to facilitate active treatment and avoid sequelae.\u003c/p\u003e\u003cp\u003ePrevious studies have shown that LGE is a marker of nonischemic cardiac tissue. However, in our study, 2 children with enhanced perfusion had no LGE but 2 children with decreased perfusion were all manifested had LGE. These findings suggest that LGE is also associated with myocardial ischemia which need more large sample studies to confirm. And all the LGE sites were in the free wall of the left ventricle in our study. It is distributed mainly in the apical segment and subepicardial region. The shape is spot-like, linear and lamellar. This is different from the findings of Cinzia Crescenzi 's study, which focused on the athletes with apparently idiopathic VA(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). This shows that there are clear differences between adults and children.\u003c/p\u003e\u003cp\u003eCompared with echocardiography, CMR allows for improved reliability in the measurement of maximum wall thickness, identification of the pattern of LV hypertrophy, and estimation of LV mass, compared to echocardiography(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). The studies of Jonathan D Windram(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e) and Yan Chao focused on pediatric patients with hypertrophic cardiomyopathy have demonstrated greater LV mass in patients with LGE(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). But in our study, the LV mass was not significantly different between the LGE group and the non-LGE group. This is likely because our study excluded children with cardiomyopathy, and the presence of an LV mass is characteristic of hypertrophic cardiomyopathy. A total of 52 children were included in this study, including 11 with PAC, 37 with PVC, and only 4 with PSVT. A large population-based study of children revealed that the morbidity of PAC was lower than that of PVC(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). In addition, in clinical practice, doctors pay more attention to nonsupracentricular arrhythmias because they are more dangerous, so more children with PVCs are hospitalized and finish CMR than PVC and PSVT. And CMR may not be performed in children with no symptoms or a low PAC burden, so the proportion of patients with symptoms and pharmacotherapy in the PAC group were greater than that in the PVC group. In our study, the LV Svi and LV EF in the PAC group were lower than those in the reference group. When the arrhythmia burden was similar, the LV Svi in the PAC group was lower than that in the PAC group, and the LGE, perfusion disorders and pericardial effusion were similar between the PAC group and the PVC group, which indicates that the PAC also affects cardiac pumping function. Hung-Yu Liu et al. found PACs were associated with infarcts of multiple vascular territories and poor function in stroke patients(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Can Hasdemir et al. found that PACs can induce myocardiopathy(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Leeper et al. found that Frequent PACs was independent predictors of atrial fibrillation(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). These findings suggest that clinicians should pay more attention to the treatment of PAC.\u003c/p\u003e\u003cp\u003eThere are several limitations in this study. First, our sample size is small. The echocardiography parameters were not included, and we didn\u0026rsquo;t measure right ventricular function. In addition, with the development of CMR technology, the value of using the cardiac magnetic resonance tissue tracking technique(CMR-TT) to evaluate myocardial strain and locate it to damaged myocardial segments is greater than that of LVEF in adult patient(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). This will be the target of our next research.\u003c/p\u003e"},{"header":"5.Conclusions","content":"\u003cp\u003eLV SV, LV Svi and LV EF are significantly decrease in children with tachyarrhythmia. PAC also affects cardiac pumping function, and clinicians should pay more attention to the treatment of PAC. Children who have a high arrhythmia burden or cardiac function decline should be actively undergo CMR. CMR provides valuable clinical information in many cases of arrhythmia in children, mainly because of its advanced ability to characterize tissue and assess the heart function. Large sample studies are needed for further confirmation. CMRs need to be performed in large populations of children to establish normal reference standards.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCMR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCardiac magnetic resonance\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ecardiac output\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ecardiac index\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLV EDV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLeft ventricle end-diastolic volume\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLV EDVi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLeft ventricle end-diastolic volume/m2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLV ESV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLeft ventricle end-systolic volume\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLV ESVi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLeft ventricle end-systolic volume/m2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLV EF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLeft ventricle ejection fraction\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLV SV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLeft ventricle stroke volume\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLGE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003elate gadolinium enhancement\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePVC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003epremature ventricular contraction\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePAC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003epremature atrial contraction\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eConflict of interest\u003c/h2\u003e\n\u003cp\u003eThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflicts of interest.\u003c/p\u003e\n\u003ch2\u003eAuthor contributions\u003c/h2\u003e\n\u003cp\u003eY-FY contributed to the collection of clinical data, the analysis and interpretation of the data, and the drafting and final approval of the manuscript. LG contributed to the collection of clinical data, the analysis and interpretation of the data, and drafting of the manuscript. BY and XY contributed to the collection of clinical data and the analysis of the data. Y-HG and Y-ZW contributed to the collection of clinical data. KS supervised the project, contributed to the conception and design of the study, to the analysis and interpretation of the data, and to the critical revision and final approval of the manuscript. All authors made substantial contributions to the study and manuscript.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThis research was supported by the Health Commission of Chengdu Municipality (2021162).\u003c/p\u003e\n\u003ch2\u003eAcknowledgments\u003c/h2\u003e\n\u003cp\u003eWe thank the Chengdu Municipal Health Commission (2021162) for their support.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eJat KR, Lodha R, Kabra SK. 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Association of Late Gadolinium Enhancement and Degree of Left Ventricular Hypertrophy Assessed on Cardiac Magnetic Resonance Imaging With Ventricular Tachycardia in Children With Hypertrophic Cardiomyopathy. \u003cem\u003eAm J Cardiol\u003c/em\u003e (2016) 117:1342\u0026ndash;1348. \u003c/li\u003e\n\u003cli\u003eChang Y, Dong M, Fan L, Kang B, Sun W, Li X, Yang Z, Ren M. Research on noninvasive electrophysiologic imaging based on cardiac electrophysiology simulation and deep learning methods for the inverse problem. \u003cem\u003eBMC Cardiovasc Disord\u003c/em\u003e (2025) 25:335. \u003c/li\u003e\n\u003cli\u003eKrynski T, Stec S, Szmit S, et al. Impact of radiofrequency catheter ablation on echocardiographic and cardiopulmonary performance in patients with ventricular extrasystolic beats and suspected arrhythmia-induced cardiomyopathy. Heart Vessels. 2014;29(6):808-816.\u003c/li\u003e\n\u003cli\u003eDukes JW, Dewland TA, Vittinghoff E, Mandyam MC, Heckbert SR, Siscovick DS, Stein PK, Psaty BM, Sotoodehnia N, Gottdiener JS, et al. Ventricular Ectopy as a Predictor of Heart Failure and Death. \u003cem\u003eJ Am Coll Cardiol\u003c/em\u003e (2015) 66:101\u0026ndash;109.\u003c/li\u003e\n\u003cli\u003eAykan HH, Karag\u0026ouml;z T, Akın A, İrdem A, \u0026Ouml;zer S, \u0026Ccedil;eliker A. Results of radiofrequency ablation in children with tachycardia-induced cardiomyopathy. Anadolu Kardiyol Derg. 2014;14(7):625-630.\u003c/li\u003e\n\u003cli\u003eMessroghli DR, Moon JC, Ferreira VM, et al. Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: A consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson. 2017;19(1):75.\u003c/li\u003e\n\u003cli\u003eLaw YM, Lal AK, Chen S, Čih\u0026aacute;kov\u0026aacute; D, Cooper LT, Deshpande S, Godown J, Grosse-Wortmann L, Robinson JD, Towbin JA, et al. Diagnosis and Management of Myocarditis in Children: A Scientific Statement From the American Heart Association. \u003cem\u003eCirculation\u003c/em\u003e (2021) 144:e123\u0026ndash;e135. \u003c/li\u003e\n\u003cli\u003eFriedrich MG, Sechtem U, Schulz-Menger J, Holmvang G, Alakija P, Cooper LT, White JA, Abdel-Aty H, Gutberlet M, Prasad S, et al. Cardiovascular magnetic resonance in myocarditis: A JACC White Paper. \u003cem\u003eJ Am Coll Cardiol\u003c/em\u003e (2009) 53:1475\u0026ndash;1487.\u003c/li\u003e\n\u003cli\u003eVan Der Ven JPG, Sadighy Z, Valsangiacomo Buechel ER, Sarikouch S, Robbers-Visser D, Kellenberger CJ, Kaiser T, Beerbaum P, Boersma E, Helbing WA. Multicentre reference values for cardiac magnetic resonance imaging derived ventricular size and function for children aged 0\u0026ndash;18 years. \u003cem\u003eEur Heart J - Cardiovasc Imaging\u003c/em\u003e (2020) 21:102\u0026ndash;113. \u003c/li\u003e\n\u003cli\u003eGr\u0026auml;ni C. How cardiac magnetic resonance is changing the management of myocarditis. \u003cem\u003eEur Heart J\u003c/em\u003e (2023) 44:909\u0026ndash;911. \u003c/li\u003e\n\u003cli\u003eNucifora G, Selvanayagam JB. Cardiac Magnetic Resonance Late Gadolinium Enhancement Imaging in Arrhythmic Risk Stratification. \u003cem\u003eHeart Lung Circ\u003c/em\u003e (2020) 29:1268\u0026ndash;1269.\u003c/li\u003e\n\u003cli\u003eCrescenzi C, Zorzi A, Vessella T, Martino A, Panattoni G, Cipriani A, De Lazzari M, Perazzolo Marra M, Fusco A, Sciarra L, et al. Predictors of Left Ventricular Scar Using Cardiac Magnetic Resonance in Athletes With Apparently Idiopathic Ventricular Arrhythmias. \u003cem\u003eJ Am Heart Assoc\u003c/em\u003e (2021) 10:e018206. \u003c/li\u003e\n\u003cli\u003eWindram JD, Benson LN, Dragelescu A, Yoo S-J, Mertens L, Wong D, Grosse-Wortmann L. Distribution of Hypertrophy and Late Gadolinium Enhancement in Children and Adolescents with Hypertrophic Cardiomyopathy. \u003cem\u003eCongenit Heart Dis\u003c/em\u003e (2015) 10:E258-267. \u003c/li\u003e\n\u003cli\u003eChaowu Y, Shihua Z, Jian L, Li L, Wei F. Cardiovascular magnetic resonance characteristics in children with hypertrophic cardiomyopathy. \u003cem\u003eCirc Heart Fail\u003c/em\u003e (2013) 6:1013\u0026ndash;1020.\u003c/li\u003e\n\u003cli\u003eNiwa K, Warita N, Sunami Y, Shimura A, Tateno S, Sugita K. Prevalence of arrhythmias and conduction disturbances in large population-based samples of children. \u003cem\u003eCardiol Young\u003c/em\u003e (2004) 14:68\u0026ndash;74. \u003c/li\u003e\n\u003cli\u003eLiu HY, Wu JY, Chung CP, et al. Premature Atrial Contractions and Their Association with Stroke Features and Outcome. J Stroke Cerebrovasc Dis. 2020;29(10):105118.\u003c/li\u003e\n\u003cli\u003eHasdemir C, Kocabas U, Kilic S, Kose S, Kilic S, Gunduz R, Ulucan C, Yagmur B, Sahin H, Celen C, et al. Premature Atrial Contraction-Induced Cardiomyopathy: Recognition of a Distinct Phenotype of Arrhythmia-Induced Cardiomyopathy in Humans. \u003cem\u003eAm J Cardiol\u003c/em\u003e (2023) 197:65\u0026ndash;67. \u003c/li\u003e\n\u003cli\u003eeeper BB. Are Premature Atrial Contractions Benign?. AACN Adv Crit Care. 2023;34(3):263-265.\u003c/li\u003e\n\u003cli\u003eWeise Vald\u0026eacute;s E, Barth P, Piran M, Laser KT, Burchert W, K\u0026ouml;rperich H. Left-Ventricular Reference Myocardial Strain Assessed by Cardiovascular Magnetic Resonance Feature Tracking and fSENC\u0026mdash;Impact of Temporal Resolution and Cardiac Muscle Mass. \u003cem\u003eFront Cardiovasc Med\u003c/em\u003e (2021) 8:764496. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Cardiac Magnetic Resonance, late gadolinium enhancement, premature ventricular contractions, premature atrial contractions, Paroxysmal superventricular tachycardia","lastPublishedDoi":"10.21203/rs.3.rs-7326756/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7326756/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis case series investigated cardiac function and structural alterations in pediatric patients with tachycardia via cardiac magnetic resonance imaging (CMR). Fifty-two children were enrolled, including 37 in the premature ventricular contraction (PVC) group, 11 in the premature atrial contraction (PAC) group and 4 in the PSVT group. ECG, 24-h Holter ECG-monitoring, echocardiogram and CMR were performed. The results revealed that in the PVC and PAC groups, 16 patients (PVC/PAC) had LGE, whereas 32 did not. No significant baseline differences existed between the PVC/PAC groups or LGE/no-LGE groups (\u003cem\u003eP\u003c/em\u003e \u0026gt; 0.05). LV EF, LV EDVi, and CO did not significantly differ between the PVC and PAC groups. Compared with LGE(-) patients, LGE(+) patients had a greater arrhythmia burden (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05) and significantly lower LV SV, LV EF, and CO versus LGE(-) (all \u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05). Compared with the reference cohort, the cohort had lower LV SV, LV Svi, and LV EF values and higher LV ESVi values(all \u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05).\u0026nbsp;Conclusion: Tachyarrhythmic children exhibit reduced LV SV, LV Svi, and LV EF. PAC impairs ventricular function. CMR provides valuable clinical insights into pediatric arrhythmias.\u003c/p\u003e\n\u003cp\u003eOur research is registered in the Chinese Clinical Trials Registry on December 13, 2021. Registration number: ChiCTR2100054326 URLhttps://www.chictr.org.cn/showprojEN.html?proj=133543\u003c/p\u003e","manuscriptTitle":"Evaluation of Cardiac Function and Structural Changes in Children with Tachycardia via Cardiac Magnetic Resonance Imaging: A Case Series Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-22 08:48:38","doi":"10.21203/rs.3.rs-7326756/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2025-09-10T14:57:17+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-18T11:08:51+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-18T09:14:18+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-18T09:11:58+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pediatrics","date":"2025-08-08T11:17:15+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"66ab17e0-a5e8-40c7-8d1e-6af7bbdd6ad4","owner":[],"postedDate":"September 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-09-22T08:48:38+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-22 08:48:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7326756","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7326756","identity":"rs-7326756","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}