Left ventricular myocardial dysfunction in arrhythmogenic cardiomyopathy with left ventricular involvement: A door to improving diagnosis

Fecha de publicación: 01/01/2019

Autores de IIS La Fe

Jorge Sanz Sánchez

Autor
Pilar Molina Aguilar

Autor
María Pilar Calvillo Batlles

Autor
Diana Domingo Valero

Autor
Luis Vicente Martínez Dolz

Autor
Esther Zorio Grima

Autor

Participantes ajenos a IIS La Fe

Vives-Gilabert, Y
Cebrian, A
Igual, B
Millet, J
Castells, F

Grupos

Cardiopatías familiares, muerte súbita y mecanismos de enfermedad (CAFAMUSME)

Investigador Principal

Aitana Braza Boils
Grupo de Investigación Clínica y Traslacional en Cardiología

Investigador Principal

Esther Roselló Lletí

Abstract

Background: Diagnostic Task Force Criteria (TFC) for arrhythmogenic cardiomyopathy (AC) exhibit poor performance for left dominant forms. TFC only include right ventricular (RV) dysfunction (akinesia, dyssynchrony, volumes and ejection fraction). Moreover, cardiac magnetic resonance imaging (CMRI) assessment of left ventricular (LV) dyssynchrony has hitherto not been described. Thus, we aimed to comprehensively characterize LVCMRI behavior in AC patients. Methods: Thirty-five AC patients with LV involvement and twenty-three non-affected family members (controls) were enrolled. Feature-tracking analysis was applied to cine CMRI to assess LV ejection fraction (LVEF), LV end-systolic and end-diastolic volume indexes, strain values and dyssynchrony. Regions with more frequent strain and dyssynchrony impairment were also studied. Results: Radial dyssynchrony and LVEF were selected (sensitivities 54.3% and 48.6%, respectively at 100% specificity), with a threshold of 70 ms for radial dyssynchrony and 48.5% for LVEF. 71.4% of patients exceeded these thresholds (31.4% both, 22.9% only dyssynchrony and 17.1% only LVEF). Considering these cut-off values as a novel combined criterion, 30% of patients with 'borderline' or 'possible' AC following 2010 TFC would move to a 'definite' AC diagnosis. Strain was globally impaired whereas dyssynchronous regions were more often apical and located at the inferolateral wall. Conclusions: Mirroring the RV evaluation, we suggest including LVEF and LV dyssynchrony to improve the diagnosis of AC. Two independent mechanisms can be claimed in AC patients with LV involvement: 1) decreased myocardial deformation with global LV affectation and 2) delayed myocardial contraction at localized regions. (c) 2018 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Datos de la publicación

ISSN/ISSNe:: 0167-5273, 1874-1754
Tipo:: Article
Páginas:: 237-244
DOI:: 10.1016/j.ijcard.2018.09.024
Factor de Impacto:: 1,082 SCImago ℠
Cuartil:: Q1 SCImago ℠

Documentos

No hay documentos

Métricas

Filiaciones

Vives-Gilabert, Y:: Univ Politecn Valencia, Inst ITACA, Camino Vera S-N, E-46022 Valencia, Spain
Sanz-Sanchez, J:: Instituto de Investigación. Inst Invest Sanitaria La Fe, Unidad Cardiopatias Familiares Muerte Subita & Me, Valencia, Spain

Hosp Univ & Politecn La Fe, Serv Cardiol, Valencia, Spain
Molina, P:: Instituto de Investigación. Inst Invest Sanitaria La Fe, Unidad Cardiopatias Familiares Muerte Subita & Me, Valencia, Spain

Inst Med Legal & Ciencias Forenses, Serv Patol, Valencia, Spain
Cebrian, A:: Univ Politecn Valencia, Inst ITACA, Camino Vera S-N, E-46022 Valencia, Spain
Igual, B:: Hosp Gen Univ, Serv Cardiol, Valencia, Spain

ERESA, Unidad Imagen Cardiaca, Valencia, Spain
Calvillo-Batlles, P:: Hosp Univ & Politecn La Fe, Serv Radiol, Valencia, Spain
Domingo, D:: Instituto de Investigación. Inst Invest Sanitaria La Fe, Unidad Cardiopatias Familiares Muerte Subita & Me, Valencia, Spain

Hosp Univ & Politecn La Fe, Serv Cardiol, Valencia, Spain
Millet, J:: Univ Politecn Valencia, Inst ITACA, Camino Vera S-N, E-46022 Valencia, Spain
Martinez-Dolz, L:: Hosp Univ & Politecn La Fe, Serv Cardiol, Valencia, Spain
Castells, F:: Univ Politecn Valencia, Inst ITACA, Camino Vera S-N, E-46022 Valencia, Spain
Zorio, E:: Instituto de Investigación. Inst Invest Sanitaria La Fe, Unidad Cardiopatias Familiares Muerte Subita & Me, Valencia, Spain

Hosp Univ & Politecn La Fe, Serv Cardiol, Valencia, Spain

Keywords

Left ventricular arrhythmogenic cardiomyopathy; Dyssynchrony; Strain; Cardiac magnetic resonance imaging; Ventricular dysfunction

Campos de estudio

Proyectos asociados

RED INVESTIGACION (RECAVA)

RD06/0014/0004 . INSTITUTO DE SALUD CARLOS III; FUNDACION PARA LA INV BIOMEDICA- HOSPITAL GREGORIO MARAÑON; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2006