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Updated: Jul 13, 2026
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Diagnosis of diffuse and localized arrhythmogenic right ventricular dysplasia by gated blood-pool SPECT
Denis Mariano-Goulart1, Laurent Déchaux, François Rouzet
1Department of Nuclear Medicine, Lapeyronie University Hospital, Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France. d-mariano_goulart@chu-montpellier.fr
Insights
The study found that the standard deviation of local times of end systole (sigma-TES) measured with gated blood-pool SPECT (GBPS) accurately diagnoses arrhythmogenic right ventricular dysplasia (ARVD). This parameter effectively distinguishes between healthy individuals and patients with diffuse or localized ARVD.
Area of Science:
- Cardiology
- Nuclear Medicine
- Medical Imaging
Background:
- Arrhythmogenic right ventricular dysplasia (ARVD) is a genetic heart muscle disease.
- Accurate diagnosis and characterization of ARVD severity are crucial for patient management.
- Global and local systolic parameters from gated blood-pool SPECT (GBPS) are being investigated for ARVD assessment.
Purpose of the Study:
- To evaluate the diagnostic and characterization capabilities of global and local systolic parameters obtained via GBPS for diffuse and localized ARVD.
- To compare the effectiveness of different GBPS-derived parameters in differentiating ARVD subtypes.
Main Methods:
- Prospective study including 59 subjects with symptomatic ventricular arrhythmias.
- Classification into non-ARVD (21 controls), localized ARVD (16 patients), and diffuse ARVD (22 patients) based on ISHFS criteria.
- Computation of right ventricular volumes, ejection fraction (EF), standard deviation of local EF (sigma-EF), and standard deviation of local times of end systole (sigma-TES) from GBPS data.
Main Results:
- Sigma-EF did not differentiate between control subjects and ARVD patients.
- Right ventricular EF and volumes distinguished diffuse ARVD from controls but not localized ARVD.
- Sigma-TES significantly differed between ARVD patients (diffuse and localized) and controls.
- Sigma-TES was the strongest systolic parameter for ARVD diagnosis, with high probabilities for detecting ARVD in both diffuse (98.5%) and localized (96.7%) forms.
- A sigma-TES threshold of 80 ms demonstrated 100% sensitivity and 81% specificity for localized ARVD diagnosis.
Conclusions:
- Gated blood-pool SPECT (GBPS) enables accurate diagnosis of both diffuse and localized ARVD.
- Calculating sigma-TES across all right ventricular pixels is a reliable method for ARVD diagnosis.
- Sigma-TES emerges as a key parameter for characterizing ARVD severity and localization.
Unlabelled:
This study aimed to assess the ability of global and local systolic parameters measured with gated blood-pool SPECT (GBPS) to diagnose and characterize the severity of diffuse or localized arrhythmogenic right ventricular dysplasia (ARVD).
Methods:
Fifty-nine subjects with symptomatic ventricular arrhythmias were prospectively included in the study. With the International Society and Federation of Cardiology criteria for ARVD as a gold standard, these subjects were classified as subjects without ARVD (21 control subjects) and patients with localized ARVD (16 patients) or diffuse ARVD (22 patients). Right ventricular volumes, right ventricular ejection fractions (EF), the SD of local EF (sigma-EF), and the SD of the local times of end systole (sigma-TES) were computed from GBPS data and compared among the groups in the study population.
Results:
sigma-EF did not differ between control subjects and patients with diffuse or localized ARVD. Right ventricular EF and volumes differed between patients with diffuse ARVD and control subjects, with similar areas under the receiver-operating-characteristic curves, but right ventricular EF and volumes failed to differentiate patients with localized ARVD. In contrast, sigma-TES differed between patients with diffuse or localized ARVD and control subjects. Regression analysis showed that the systolic parameter most strongly associated with the diagnosis of ARVD was sigma-TES. The probabilities of a randomly chosen patient in the diffuse ARVD group and of a randomly chosen patient in the localized ARVD group having sigma-TES values greater than that of a randomly chosen control subject were 98.5% and 96.7%, respectively. For the diagnosis of localized ARVD, a threshold of 80 ms for sigma-TES corresponded to sensitivity, specificity, and positive and negative predictive values of 100%, 81%, 80%, and 100%, respectively.
Conclusion:
With GBPS, both diffuse ARVD and localized ARVD can be accurately diagnosed by computing sigma-TES for all of the pixels on the surface of the right ventricle.
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