| Autor: |
Aljehani A; Institute of Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK.; Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK.; Echocardiography Cardiovascular Technology (ECVT) Program, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia., Win KZ; Institute of Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK.; Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK., Baig S; Institute of Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK.; Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK., Kalla M; Institute of Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK.; Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK., Ensam B; Institute of Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK.; Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK., Fabritz L; Institute of Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK.; Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK.; University Center for Cardiovascular Science & Department of Cardiology, University Heart and Vascular Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Martinistrasse 52, 20246 Hamburg, Germany., Steeds RP; Institute of Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK.; Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK. |
| Abstrakt: |
Background Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare genetic disorder associated with an elevated risk of life-threatening arrhythmias and progressive ventricular impairment. Risk stratification is essential to prevent major adverse cardiac events (MACE). Our study aimed to investigate the incremental value of strain measured by two-dimensional speckle-tracking echocardiography in predicting MACE in ARVC patients compared to conventional echocardiographic parameters. Methods and Results This was a retrospective, single-centre cohort study of 83 patients with ARVC (51% males, median age 37 years (IQR: 23, 53)) under the care of the Inherited Cardiac Conditions clinic at University Hospital Birmingham. MACE was defined as one of the following: sustained ventricular tachycardia (Sus VT), ventricular fibrillation (VF), appropriate implantable cardio-defibrillator (ICD) therapy [shock/anti-tachycardia pacing (ATP)], heart failure (defined as decompensated heart failure, cardiac index by heart catheter, HF medication, and symptoms), cardiac transplantation, or cardiac death. Echocardiography images were analysed by a single observer for right ventricle (RV) and left ventricular (LV) global longitudinal strain (GLS). Multivariable Cox regression was performed in combination with RV fractional area change and tricuspid annular plane systolic excursion. During three years of follow-up, 12% of patients suffered a MACE. ARVC patients with MACE had significantly reduced RV GLS (-13 ± 6% vs. -23 ± 6%, p < 0.001) and RV free wall longitudinal strain (-15 ± 5% vs. -25 ± 7%, p < 0.001) compared to those without MACE. Conclusions Right ventricular free wall longitudinal strain (RVFWLS) may be a more sensitive predictor of MACE than conventional echocardiographic parameters of RV function. Moreover, RV-free wall longitudinal strain may have superior predictive value compared to RV GLS. |
