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Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
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Left Ventricular Involvement in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Assessed by

Thomas P Mast1, Arco J Teske1, Jeroen F vd Heijden1

  • 1Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|May 31, 2015
PubMed

Insights

Deformation imaging detects significant left ventricular involvement in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C), identifying patients at higher risk for cardiac events. This advanced technique surpasses conventional echocardiography in assessing ARVD/C progression.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Genetics

Background:

  • Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) phenotype studies show discrepancies in left ventricular (LV) involvement.
  • The ability of echocardiographic techniques to detect LV involvement in ARVD/C is unclear.
  • Accurate LV involvement detection may identify ARVD/C patients at increased risk for cardiac events.

Purpose of the Study:

  • To evaluate conventional and deformation imaging for detecting LV involvement in ARVD/C.
  • To determine if LV involvement detected by echocardiography predicts cardiac events in ARVD/C patients.

Main Methods:

  • 38 ARVD/C patients, 16 mutation-positive relatives, and 55 controls underwent conventional and deformation echocardiography.
  • Cardiac MRI with late enhancement was performed in a subgroup (n=27).
  • All subjects were followed for cardiac events.

Main Results:

  • Deformation imaging identified LV involvement in 68% of ARVD/C patients and 25% of relatives, correlating with MRI findings.
  • Conventional echocardiography detected LV involvement in only 32% of ARVD/C patients.
  • LV involvement by deformation imaging (HR 4.9) and RV outflow tract enlargement (HR 1.2) were independent predictors of adverse outcomes.

Conclusions:

  • Deformation imaging is superior to conventional echocardiography for detecting LV involvement in ARVD/C.
  • A high incidence of LV involvement exists in ARVD/C patients and their relatives.
  • LV involvement and RV outflow tract enlargement are key prognostic markers in ARVD/C.
Abstract

Keywords:
ARVD/CArrhythmogenic right ventricular cardiomyopathyDeformation imagingEchocardiographyLV involvementPrognosis

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