BACKGROUND: Cardiac magnetic resonance (CMR) evaluation of athletes for arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is complicated by overlapping features such as right ventricular (RV) volume increase. The revised ARVC/D diagnostic Task Force Criteria (TFC) incorporate cut-off values for RV ejection fraction (EF) and RV end-diastolic volume (EDV) on CMR. DESIGN: To distinguish ARVC/D patients from athletes we compared CMR ventricular volumes, function, TFC cut-off values, and LV/RV ratios since athletes show proportionate, and ARVC/D patients disproportionate, changes in LV and RV. METHODS: Quantitative CMR parameters of 33 ARVC/D patients (64% male, mean age 45.4 years, diagnosed by revised TFC), 66 healthy athletes and 66 healthy non-athletes (sex and age matched) were compared using revised TFC and new cut-off values representing LV/RV balance. RESULTS AND CONCLUSIONS: Absolute values for ARVC/D patients/athletes/non-athletes were: in males, RV EDV 149/133/106 ml/m(2), ratio EDV LV/RV 0.70/0.91/0.93, RV EF 34/52/54%, LV EF 48/57/58%, ratio EF LV/RV 1.49/1.10/1.09; and in females, RV EDV 115/115/91 ml/m(2), ratio EDV LV/RV 0.86/0.94/0.97, RV EF 43/54/58%, LV EF 52/57/61%, ratio EF LV/RV 1.23/1.08/1.04 (p-values < 0.05). Areas under the ROC-curve are 0.68 (RV EDV index), 0.84 (LV/RV EDV ratio) and 0.93 (RV EF), demonstrating significantly (p < 0.001) better performance of RV EF and LV/RV EDV ratio. If a wall motion abnormality is present (observed in 30 ARVC/D patients and not in healthy subjects), RV EF can help distinguish ARVC/D from physiological cardiac adaptation in athletes on CMR whereas RV EDV index cannot. A good alternative in athletes is the LV/RV EDV ratio, representing normal proportionate adaptation of both ventricles.
BACKGROUND: Cardiac magnetic resonance (CMR) evaluation of athletes for arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is complicated by overlapping features such as right ventricular (RV) volume increase. The revised ARVC/D diagnostic Task Force Criteria (TFC) incorporate cut-off values for RV ejection fraction (EF) and RV end-diastolic volume (EDV) on CMR. DESIGN: To distinguish ARVC/D patients from athletes we compared CMR ventricular volumes, function, TFC cut-off values, and LV/RV ratios since athletes show proportionate, and ARVC/D patients disproportionate, changes in LV and RV. METHODS: Quantitative CMR parameters of 33 ARVC/D patients (64% male, mean age 45.4 years, diagnosed by revised TFC), 66 healthy athletes and 66 healthy non-athletes (sex and age matched) were compared using revised TFC and new cut-off values representing LV/RV balance. RESULTS AND CONCLUSIONS: Absolute values for ARVC/D patients/athletes/non-athletes were: in males, RV EDV 149/133/106 ml/m(2), ratio EDV LV/RV 0.70/0.91/0.93, RV EF 34/52/54%, LV EF 48/57/58%, ratio EF LV/RV 1.49/1.10/1.09; and in females, RV EDV 115/115/91 ml/m(2), ratio EDV LV/RV 0.86/0.94/0.97, RV EF 43/54/58%, LV EF 52/57/61%, ratio EF LV/RV 1.23/1.08/1.04 (p-values < 0.05). Areas under the ROC-curve are 0.68 (RV EDV index), 0.84 (LV/RV EDV ratio) and 0.93 (RV EF), demonstrating significantly (p < 0.001) better performance of RV EF and LV/RV EDV ratio. If a wall motion abnormality is present (observed in 30 ARVC/D patients and not in healthy subjects), RV EF can help distinguish ARVC/D from physiological cardiac adaptation in athletes on CMR whereas RV EDV index cannot. A good alternative in athletes is the LV/RV EDV ratio, representing normal proportionate adaptation of both ventricles.
Authors: Nadine Kawel-Boehm; Scott J Hetzel; Bharath Ambale-Venkatesh; Gabriella Captur; Christopher J Francois; Michael Jerosch-Herold; Michael Salerno; Shawn D Teague; Emanuela Valsangiacomo-Buechel; Rob J van der Geest; David A Bluemke Journal: J Cardiovasc Magn Reson Date: 2020-12-14 Impact factor: 5.364
Authors: Marina Cerrone; Grecia M Marrón-Liñares; Chantal J M van Opbergen; Sarah Costa; Mimount Bourfiss; Marta Pérez-Hernández; Florencia Schlamp; Fabian Sanchis-Gomar; Kabir Malkani; Kamelia Drenkova; Mingliang Zhang; Xianming Lin; Adriana Heguy; Birgitta K Velthuis; Niek H J Prakken; Andre LaGerche; Hugh Calkins; Cynthia A James; Anneline S J M Te Riele; Mario Delmar Journal: Eur Heart J Date: 2022-03-21 Impact factor: 35.855
Authors: David Dorian; Diptendu Chatterjee; Kim A Connelly; Jack M Goodman; Andrew T Yan; Robert F Bentley; Laura Banks; Robert M Hamilton; Paul Dorian Journal: CJC Open Date: 2021-07-14
Authors: Robyn Bryde; Andres I Applewhite; Abd Moain Abu Dabrh; Bryan J Taylor; Michael G Heckman; Sara E Filmalter; George Pujalte; Carlos Rojas; Alexander J Heckman; Tara J Brigham; Larry J Prokop; Brian P Shapiro Journal: Physiol Rep Date: 2021-12
Authors: Giovanni Quarta; Syed I Husain; Andrew S Flett; Daniel M Sado; Charles Y Chao; Marıá T Tomé Esteban; William J McKenna; Antonios Pantazis; James C Moon Journal: J Cardiovasc Magn Reson Date: 2013-02-11 Impact factor: 5.364