Advanced quantitative echocardiography in arrhythmogenic right ventricular cardiomyopathy

J Am Soc Echocardiogr. 2007 Jan;20(1):27-35. doi: 10.1016/j.echo.2006.07.006.

Abstract

Background: Arrhythmogenic right ventricular (RV) cardiomyopathy (ARVC) is a regional disease of the RV myocardium with variable degrees of left ventricular involvement. Three-dimensional echocardiography and Doppler tissue imaging (DTI) are new echocardiographic modalities for the evaluation of global and regional function, but the diagnostic potential remains to be assessed.

Methods: Twenty patients with previously established ARVC were evaluated by 3-dimensional echocardiography and DTI, and compared with 32 age- and sex-matched control subjects.

Results: Using 3-dimensional echocardiography, patients with ARVC had a decreased RV ejection fraction (0.47 +/- 0.08 vs 0.53 +/- 0.05, P < .01), and a decreased peak lateral systolic annular velocity by pulsed wave imaging of both the RV (11.9 +/- 2.6 vs 15.1 +/- 3.7 cm/s, P < .01) and the left ventricle (7.0 +/- 2.6 vs 9.5 +/- 1.9 cm/s, P < .01). DTI showed decreased regional systolic strain, but with wide variation in the measurements.

Conclusion: Three-dimensional echocardiography identifies decreased RV ejection fraction in ARVC. Assessment of regional contractility by DTI is limited by wide variation. Echocardiographic evaluation of the longitudinal motility appears to be a sensitive marker of preclinical left ventricular involvement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Arrhythmogenic Right Ventricular Dysplasia / diagnosis
  • Arrhythmogenic Right Ventricular Dysplasia / diagnostic imaging*
  • Atrial Natriuretic Factor / blood*
  • Biomarkers / blood
  • Biopsy, Needle
  • Case-Control Studies
  • Confidence Intervals
  • Echocardiography / methods
  • Echocardiography, Three-Dimensional / methods*
  • Female
  • Heart Function Tests
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Probability
  • Reference Values
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Ventricular Dysfunction, Right / diagnostic imaging
  • Ventricular Dysfunction, Right / physiopathology

Substances

  • Biomarkers
  • Natriuretic Peptide, Brain
  • Atrial Natriuretic Factor