Abstract 16201: Frequent Left Ventricular Dysfunction In Patients With Arrhythmogenic Right Ventricular Cardiomyopathy
Background: Recent reports indicate that left ventricular (LV) impairment is more frequent in ARVC patients than earlier suggested. Myocardial strain by echocardiography is a sensitive tool for assessing cardiac function. The purpose of this study was to investigate how frequently LV function is reduced in patients with established ARVC.
Methods: We included 36 patients with an ARVC diagnosis according to current guidelines. 27 healthy individuals served as control group. Strain measurements were assessed by speckle tracking echocardiography. RV strain was calculated in the 3 lateral RV segment and LV strain in a 16 LV segment model.
Results: Ventricular arrhythmias were documented in all ARVC patients. ARVC patients had significantly reduced strain in RV (-19.3±6.8% vs. -29.1±6.7%, p<0.001) and LV (-16.5±4.7% vs. -22.4±2.6%, p<0.001) compared to healthy individuals. ARVC patients had lower LV ejection fraction (57±14% vs. 64±5%, p=0.01). LV strain was significantly correlated to RV lateral strain in ARVC patients (R=0.77, p<0.001) indicating a close relationship in ventricular function (Figure). Reduced LV strain (<-20%) was found in 27 patients (75%), and 28 patients (78%) had reduced RV strain (<-25%). Reduced LV strain was present in 5 patients (14%) despite normal RV strain and 4 patients (11%) had reduced RV strain with normal LV strain.
Conclusion: Systolic function was concomitantly reduced in both ventricles, confirming that ARVC is a biventricular disease. Isolated reduction in LV function did occur in a few cases. ARVC diagnosis should be considered even in patients with merely LV dysfunction and ventricular arrhythmias. Myocardial strain may be a useful tool in quantifying RV and LV function in patients with ARVC.
- © 2010 by American Heart Association, Inc.