Alexander Gotschy1,2,3, Ardan M Saguner1, Markus Niemann1,4, Sandra Hamada5, Deniz Akdis1, Ji-Na Yoon1, Elena V Parmon6, Victoria Delgado7, Jeroen J Bax7, Sebastian Kozerke2, Corinna Brunckhorst1, Firat Duru1, Felix C Tanner1, Robert Manka1,2,8. 1. Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland. 2. Institute for Biomedical Engineering, University and ETH Zurich Gloriastrasse 35, 8092 Zurich, Switzerland. 3. Division of Internal Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland. 4. Faculty of Mechanical and Medical Engineering, Furtwangen University, Jakob-Kienzle-Strasse 17, 78054 Villingen-Schwenningen, Germany. 5. Department of Cardiology, Pneumology, Angiology and Intensive Care Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. 6. Institute of Heart and Vessels, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russia. 7. Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, The Netherlands. 8. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
Abstract
Aims: Right ventricular outflow tract (RVOT) dilation is one of the echocardiographic criteria in the 2010 revised Task Force Criteria (TFC) of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). However, studies comparing cardiac magnetic resonance (CMR) and transthoracic echocardiography (TTE) suggest a lower diagnostic accuracy of TTE due to its operator dependence and limited reproducibility. The goal of this study was to compare the 2010 TFC measures of RVOT dilation with three alternative measures for improving the echocardiographic assessment of RVOT in patients with ARVC/D. Methods and results: In this multicentre study, CMR and TTE were performed in 38 patients with a definite, borderline, or possible ARVC/D diagnosis and in 10 healthy controls. Besides the echocardiographic RVOT measurements listed by the 2010 TFC, we assessed three additional end-diastolic RVOT diameters. These included the RVOT diameter defined by the parasternal long axis M-mode of the aortic sinus portion (RVOT3), that defined by the parasternal long axis M-mode of the left ventricle (RVOT4), and that obtained by the parasternal short axis view of the distal RVOT proximal to the pulmonary valve (RVOT5). RVOT4 provided the best correlation between CMR and TTE (r = 0.92, [95% confidence interval (CI): 0.84-0.96; P < 0.0001]) and enhanced diagnostic accuracy for diagnosing ARVC/D (area under the curve 0.92 [95% CI, 0.78-0.98]). Conclusion: Among all RVOT diameters examined, that defined by the parasternal long axis M-mode of the left ventricle (RVOT4) provides the best agreement between CMR and TTE and exhibits the best diagnostic accuracy for ARVC/D. This novel RVOT4 measurement carries the potential for improving the echocardiographic diagnosis of ARVC/D.
Aims: Right ventricular outflow tract (RVOT) dilation is one of the echocardiographic criteria in the 2010 revised Task Force Criteria (TFC) of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). However, studies comparing cardiac magnetic resonance (CMR) and transthoracic echocardiography (TTE) suggest a lower diagnostic accuracy of TTE due to its operator dependence and limited reproducibility. The goal of this study was to compare the 2010 TFC measures of RVOT dilation with three alternative measures for improving the echocardiographic assessment of RVOT in patients with ARVC/D. Methods and results: In this multicentre study, CMR and TTE were performed in 38 patients with a definite, borderline, or possible ARVC/D diagnosis and in 10 healthy controls. Besides the echocardiographic RVOT measurements listed by the 2010 TFC, we assessed three additional end-diastolic RVOT diameters. These included the RVOT diameter defined by the parasternal long axis M-mode of the aortic sinus portion (RVOT3), that defined by the parasternal long axis M-mode of the left ventricle (RVOT4), and that obtained by the parasternal short axis view of the distal RVOT proximal to the pulmonary valve (RVOT5). RVOT4 provided the best correlation between CMR and TTE (r = 0.92, [95% confidence interval (CI): 0.84-0.96; P < 0.0001]) and enhanced diagnostic accuracy for diagnosing ARVC/D (area under the curve 0.92 [95% CI, 0.78-0.98]). Conclusion: Among all RVOT diameters examined, that defined by the parasternal long axis M-mode of the left ventricle (RVOT4) provides the best agreement between CMR and TTE and exhibits the best diagnostic accuracy for ARVC/D. This novel RVOT4 measurement carries the potential for improving the echocardiographic diagnosis of ARVC/D.
Authors: James P Pirruccello; Paolo Di Achille; Victor Nauffal; Mahan Nekoui; Samuel F Friedman; Marcus D R Klarqvist; Mark D Chaffin; Lu-Chen Weng; Jonathan W Cunningham; Shaan Khurshid; Carolina Roselli; Honghuang Lin; Satoshi Koyama; Kaoru Ito; Yoichiro Kamatani; Issei Komuro; Sean J Jurgens; Emelia J Benjamin; Puneet Batra; Pradeep Natarajan; Kenney Ng; Udo Hoffmann; Steven A Lubitz; Jennifer E Ho; Mark E Lindsay; Anthony A Philippakis; Patrick T Ellinor Journal: Nat Genet Date: 2022-06-13 Impact factor: 41.307
Authors: Belinda Gray; Ganesh Kumar Gnanappa; Richard D Bagnall; Giuseppe Femia; Laura Yeates; Jodie Ingles; Charlotte Burns; Rajesh Puranik; Stuart M Grieve; Christopher Semsarian; Raymond W Sy Journal: PLoS One Date: 2018-04-13 Impact factor: 3.240
Authors: Xiaodan Zhao; Liwei Hu; Shuang Leng; Ru-San Tan; Ping Chai; Jennifer Ann Bryant; Lynette L S Teo; Marielle V Fortier; Tee Joo Yeo; Rong Zhen Ouyang; John C Allen; Marina Hughes; Pankaj Garg; Shuo Zhang; Rob J van der Geest; James W Yip; Teng Hong Tan; Ju Le Tan; Yumin Zhong; Liang Zhong Journal: J Cardiovasc Magn Reson Date: 2022-01-03 Impact factor: 5.364