Diagnostic and Prognostic Value of Right Ventricular Fat Quantification from Computed Tomography in Arrhythmogenic Right Ventricular Cardiomyopathy.

Autor: Faga V; Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain.; BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d'Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain., Ruiz Cueto M; Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain., Viladés Medel D; Cardiology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain.; Cardiac Imaging Unit, Hospital de la Creu Blanca, 08034 Barcelona, Spain.; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain., Moreno-Weidmann Z; Cardiology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Dallaglio PD; Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain.; BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d'Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain., Diez Lopez C; Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain.; BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d'Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain., Roura G; Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain.; BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d'Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain., Guerra JM; Cardiology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain.; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain.; Institut de Recerca Sant Pau, 08041 Barcelona, Spain.; Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain., Leta Petracca R; Cardiology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain.; Cardiac Imaging Unit, Hospital de la Creu Blanca, 08034 Barcelona, Spain., Gomez-Hospital JA; Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain.; BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d'Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain., Comin Colet J; Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain.; BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d'Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain.; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain.; Innovation, Research and Universities Department, Gerència Territorial Metropolitana Sud, Institut Català de la Salut, Hospitalet de Llobregat, 08907 Barcelona, Spain.; Department of Clinical Sciences, School of Medicine, University of Barcelona, 08007 Barcelona, Spain., Anguera I; Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain.; BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d'Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain., Di Marco A; Cardiology Department, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain.; BIOHEART Group, Cardiovascular, Respiratory and Systemic Disease and Cellular Aginf Program, Institut d'Investigación Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2024 Jun 24; Vol. 13 (13). Date of Electronic Publication: 2024 Jun 24.
DOI: 10.3390/jcm13133674
Abstrakt: Background: In arrhythmogenic right ventricular cardiomyopathy (ARVC) non-invasive scar evaluation is not included among the diagnostic criteria or the predictors of ventricular arrhythmias (VA) and sudden death (SD). Computed tomography (CT) has excellent spatial resolution and allows a clear distinction between myocardium and fat; thus, it has great potential for the evaluation of myocardial scar in ARVC. Objective: The objective of this study is to evaluate the feasibility, and the diagnostic and prognostic value of semi-automated quantification of right ventricular (RV) fat replacement from CT images. Methods: An observational case-control study was carried out including 23 patients with a definite (19) or borderline (4) ARVC diagnosis and 23 age- and sex-matched controls without structural heart disease. All patients underwent contrast-enhanced cardiac CT. RV images were semi-automatically reconstructed with the ADAS-3D software (ADAS3D Medical, Barcelona, Spain). A fibrofatty scar was defined as values of Hounsfield Units (HU) <-10. Within the scar, a border zone (between -10 HU and -50 HU) and dense scar (<-50 HU) were distinguished. Results: All ARVC patients had an RV scar and all scar-related measurements were significantly higher in ARVC cases than in controls ( p < 0.001). The total scar area and dense scar area showed no overlapping values between cases and controls, achieving perfect diagnostic performance (sensitivity and specificity of 100%). Among ARVC patients, 16 (70%) had experienced sustained VA or aborted SD. Among all clinical, ECG and imaging parameters, the dense scar area was the only one with a statistically significant association with VA and SD ( p = 0.003). Conclusions: In ARVC, RV myocardial fat quantification from CT is feasible and may have considerable diagnostic and prognostic value.
Databáze: MEDLINE
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