Abstract 1968: Echocardiographic Tissue Deformation Imaging Of The Right Ventricle - A Reliable Technique To Identify Abnormal Regional Function In Arrhythmogenic Right Ventricular Dysplasia/cardiomyopathy
INTRODUCTION: Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) is a cardiomyopathy characterized by fibro-fatty myocardial replacement predominantly in the right ventricle (RV) resulting in RV functional and morphological changes which provide a substrate for arrhythmias and heart failure. Based on visual echocardiographic assessment diagnosis is difficult, and RV dilatation is nonspecific. We hypothesize that new objective and quantitative echocardiographic parameters, such as strain and strain-rate imaging, could reliably identify regional abnormal deformation properties in ARVD/C patients.
METHODS: 17 ARVD/C patients (confirmed by Task Force criteria) and 18 healthy controls were prospectively enrolled. Conventional echocardiography including tissue Doppler imaging (TDI) was performed. Doppler derived velocity, strain and strain-rate were calculated in the RV free wall in the apical, mid and basal segment.
RESULTS: RV dimensions were significantly increased in ARVD/C patients (RVOT 26.4 ± 5.5 vs 40.5 ± 11.5 mm, p<0.001; RVIT 36.6 ± 5.3 vs 47.9 ±9.5 mm, p<0.0001), whereas LV dimensions were not significantly different compared to controls. Strain and strain rate values were significantly lower in ARVD/C patients in all three segments (see, table⇓). All deformation parameters showed a higher accuracy to detect functional abnormalities associated with ARVD/C compared to conventional echocardiographic criteria (major Task Force criteria on ultrasound) (area under the curve (AUC) 0.84). The lowest strain value in any of the three analyzed segments showed the best receiver operating characteristics (AUC 0.97).
CONCLUSION: TDI derived parameters are superior to conventional echocardiographic parameters in identifying ARVD/C. This novel technique could have additional value in the diagnostic work up of patients suspected of ARVD/C.