Different Prognostic Value of Functional Right Ventricular Parameters in Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia
| Autor: | Ardan M. Saguner, Robert Manka, Etienne Delacrétaz, Argelia Medeiros-Domingo, Felix C. Tanner, Rolf Jenni, Thomas F. Lüscher, Andreas S. Mueller-Burri, Sina Rüeger, Guy Fontaine, Samuel H. Baldinger, Patric Biaggi, Firat Duru, Laurent M. Haegeli, Leonhard Held, Corinna Brunckhorst, Alessandra Vecchiati |
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| Přispěvatelé: | University of Zurich, Tanner, Felix C |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors 610 Medicine & health Risk Assessment 2705 Cardiology and Cardiovascular Medicine Right ventricular cardiomyopathy Sudden cardiac death 170 Ethics Risk Factors Interquartile range Internal medicine Confidence Intervals medicine 2741 Radiology Nuclear Medicine and Imaging Humans 10237 Institute of Biomedical Engineering Radiology Nuclear Medicine and imaging Heart Atria Arrhythmogenic Right Ventricular Dysplasia Proportional Hazards Models Retrospective Studies Body surface area business.industry Incidence Hazard ratio 10060 Epidemiology Biostatistics and Prevention Institute (EBPI) Middle Aged Prognosis medicine.disease Echocardiography Doppler Color Arrhythmogenic right ventricular dysplasia Survival Rate Death Sudden Cardiac ROC Curve Ventricular Fibrillation Ventricular fibrillation 10209 Clinic for Cardiology Disease Progression Ventricular Function Right Cardiology Female Cardiology and Cardiovascular Medicine business Switzerland Mace Follow-Up Studies |
| Zdroj: | Circulation: Cardiovascular Imaging. 7:230-239 |
| ISSN: | 1942-0080 1941-9651 |
| DOI: | 10.1161/circimaging.113.000210 |
| Popis: | Background— The value of standard 2-dimensional transthoracic echocardiographic parameters for risk stratification in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is controversial. Methods and Results— We investigated the impact of RV fractional area change (FAC) and tricuspid annulus plane systolic excursion (TAPSE) for the prediction of major adverse cardiovascular events (MACE) defined as the occurrence of cardiac death, heart transplantation, survived sudden cardiac death, ventricular fibrillation, sustained ventricular tachycardia, or arrhythmogenic syncope. Among 70 patients who fulfilled the 2010 ARVC/D Revised Task Force Criteria and underwent baseline transthoracic echocardiography, 37 (53%) patients experienced MACE during a median follow-up period of 5.3 (interquartile range, 1.8–9.8) years. Average values for FAC, TAPSE, and TAPSE indexed to body surface area (BSA) decreased over time ( P =0.03 for FAC, P =0.03 for TAPSE, and P =0.01 for TAPSE/BSA, each versus baseline). In contrast, median RV end-diastolic area increased ( P =0.001 versus baseline). Based on the results of Kaplan–Meier estimates, the time between baseline transthoracic echocardiography and experiencing MACE was significantly shorter for patients with FAC P P =0.02), or right atrial short axis/BSA ≥25 mm/m 2 ( P =0.04) at baseline. A reduced FAC constituted the strongest predictor of MACE (hazard ratio, 1.08 per 1% decrease; 95% confidence interval, 1.04–1.12; P Conclusions— This long-term observational study indicates that TAPSE and dilation of right-sided cardiac chambers are associated with an increased risk for MACE in patients with ARVC/D with advanced disease and a high risk for adverse events. However, FAC is the strongest echocardiographic predictor of adverse outcome in these patients. Our data advocate a role for transthoracic echocardiography in risk stratification in patients with ARVC/D, although our results may not be generalizable to lower-risk ARVC/D cohorts. |
| Databáze: | OpenAIRE |
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