Abstract 19853: Role of Velocity Vector Imaging Derived Strain Parameters in Arrhythmogenic Right Ventricular Cardiomyopathy
Background: Velocity Vector imaging (VVI) is a novel echocardiographic technique that has the unique ability to quantify myocardial deformation. The feasibility of this new imaging tool has already been proven in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). However, limited data regarding the clinical usefulness of VVI derived strain parameters in ARVC are currently available.
Objective: To examine the relation between right ventricular (RV) dysfunction assessed by novel indices of myocardial deformation and sustained ventricular arrhythmia (SVA) in ARVC patients.
Methods: We retrospectively analyzed the 2D echocardiograms with VVI (syngo, Siemens) of 55 patients with a definite ARVC diagnosis. The study population was divided into two groups according to the presence (group A) or absence (group B) of SVA during follow-up. We compared the echocardiographic features between group A (15 patients) at the time of SVA onset (range of ±12 months) and group B (40 patients) at the last available echocardiogram. Standard 2D and VVI strain measurements were performed. RV segmental and global longitudinal peak systolic strain was assessed in a six segment RV model. Association between echocardiographic parameters and SVA was investigated by ordinal logistic regression models.
Results: At the time of arrhythmia onset, group A patients had a significantly greater RV dilation than group B (RV end diastolic area: 38±11 versus 28±9 mm, respectively; p=0.008) and a much higher prevalence of both RV dysfunction (100% vs. 68%; p=0.02) and severe RV dysfunction (67% vs. 18%; p=0.002). Absolute global longitudinal RV strain was significantly lower in group A respect to group B (-14±3 versus -17±4; p=0.006). Left ventricular (LV) volume was slightly larger in group A respect to group B (indexed LV end diastolic volume: 49±12 ml/m2 versus 47±17 ml/m2: p=0.04). However ejection fraction did not vary between groups. Significant association was observed between the presence of severe RV dysfunction and SVA (OR: 8.58; CI:2-36.7; p=0.004) and global longitudinal RV strain and SVA (OR: 1.23; CI: 1.05-1-45: p=0.01).
Conclusion: RV dysfunction assessed by fractional area change and VVI strain parameters were significantly correlated with SVA in ARVC.
Author Disclosures: A.M. Dragos: None. J. Dorosz: None. B. Pinamonti: None. F. Brun: None. L. Mestroni: None. M.R. Taylor: None. G. Sinagra: None.
- © 2014 by American Heart Association, Inc.