Body surface potential mapping detects early disease onset in plakophilin-2-pathogenic variant carriers.

Autor:	Kloosterman M; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands., Boonstra MJ; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands., Roudijk RW; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands., Bourfiss M; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands., van der Schaaf I; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands., Velthuis BK; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands., Eijsvogels TMH; Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands., Kirkels FP; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands., van Dam PM; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.; ECG-Excellence BV, Nieuwerbrug, The Netherlands., Loh P; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2023 Jul 04; Vol. 25 (7).
DOI:	10.1093/europace/euad197
Abstrakt:	Aims: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a progressive inherited cardiac disease. Early detection of disease and risk stratification remain challenging due to heterogeneous phenotypic expression. The standard configuration of the 12 lead electrocardiogram (ECG) might be insensitive to identify subtle ECG abnormalities. We hypothesized that body surface potential mapping (BSPM) may be more sensitive to detect subtle ECG abnormalities. Methods and Results: We obtained 67 electrode BSPM in plakophilin-2 (PKP2)-pathogenic variant carriers and control subjects. Subject-specific computed tomography/magnetic resonance imaging based models of the heart/torso and electrode positions were created. Cardiac activation and recovery patterns were visualized with QRS- and STT-isopotential map series on subject-specific geometries to relate QRS-/STT-patterns to cardiac anatomy and electrode positions. To detect early signs of functional/structural heart disease, we also obtained right ventricular (RV) echocardiographic deformation imaging. Body surface potential mapping was obtained in 25 controls and 42 PKP2-pathogenic variant carriers. We identified five distinct abnormal QRS-patterns and four distinct abnormal STT-patterns in the isopotential map series of 31/42 variant carriers. Of these 31 variant carriers, 17 showed no depolarization or repolarization abnormalities in the 12 lead ECG. Of the 19 pre-clinical variant carriers, 12 had normal RV-deformation patterns, while 7/12 showed abnormal QRS- and/or STT-patterns. Conclusion: Assessing depolarization and repolarization by BSPM may help in the quest for early detection of disease in variant carriers since abnormal QRS- and/or STT-patterns were found in variant carriers with a normal 12 lead ECG. Because electrical abnormalities were observed in subjects with normal RV-deformation patterns, we hypothesize that electrical abnormalities develop prior to functional/structural abnormalities in ARVC. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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