TY - JOUR
T1 - Utility of Tissue Doppler and Strain Echocardiography in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
AU - Prakasa, Kalpana R.
AU - Wang, Jianwen
AU - Tandri, Harikrishna
AU - Dalal, Darshan
AU - Bomma, Chandra
AU - Chojnowski, Roman
AU - James, Cynthia
AU - Tichnell, Crystal
AU - Russell, Stuart
AU - Judge, Daniel
AU - Corretti, Mary
AU - Bluemke, David
AU - Calkins, Hugh
AU - Abraham, Theodore P.
N1 - Funding Information:
This study was supported in part by a private grant from the Bogle Foundation, Valley Forge, Pennsylvania, and grants from the National Institutes of Health, Bethesda, Maryland (HL65594) and the National Football League, New York, New York.
PY - 2007/8/1
Y1 - 2007/8/1
N2 - Arrhythmogenic right ventricular dysplasia (ARVD) is a heritable cardiomyopathy characterized by the fibrofatty replacement of right ventricular (RV) myocardium leading to RV failure and arrhythmias. This study evaluated the potential utility of tissue Doppler echocardiography (TDE) and strain echocardiography (SE) to quantitatively assess RV function and their potential role in diagnosing ARVD. Images of 30 patients with ARVD (diagnosed by task force criteria) and 36 healthy controls were obtained. Peak systolic velocity, early diastolic velocity, displacement, strain rate, strain, outflow tract diameter, and fractional RV area change were measured in all subjects. Peak RV systolic velocity (6.4 ± 2.2 vs 9 ± 1.6 cm/s, p <0.0001), early diastolic velocity (-6.7 ± 2.7 vs -9.4 ± 2 cm/s, p <0.0001), displacement (13.7 ± 5.8 vs 18.7 ± 3.5 mm, p <0.0003), strain rate (-1 ± 0.7 vs -2 ± 1 s-1, p = 0.002), and strain (-10 ± 6% vs -28 ± 11%, p = 0.001) were significantly lower in patients with ARVD compared with controls, respectively. Sensitivity and specificity, respectively, were 67% and 89% for systolic velocity, 77% and 71% for displacement, 73% and 87% for strain, 50% and 96% for strain rate, 53% and 93% for outflow tract diameter, and 47% and 83% for fractional area change. RV systolic velocity and displacement were significantly lower than in controls, even in the subset of patients with ARVD with apparently normal right ventricles by conventional echocardiography. Inter- and intraobserver agreement was high. In conclusion, TDE and SE enable the detection of ARVD via the quantification of RV function and may have potential clinical value in the assessment of patients with suspected ARVD. Peak RV systolic velocity <7.5 cm/s and peak RV strain <18% best identify patients with ARVD.
AB - Arrhythmogenic right ventricular dysplasia (ARVD) is a heritable cardiomyopathy characterized by the fibrofatty replacement of right ventricular (RV) myocardium leading to RV failure and arrhythmias. This study evaluated the potential utility of tissue Doppler echocardiography (TDE) and strain echocardiography (SE) to quantitatively assess RV function and their potential role in diagnosing ARVD. Images of 30 patients with ARVD (diagnosed by task force criteria) and 36 healthy controls were obtained. Peak systolic velocity, early diastolic velocity, displacement, strain rate, strain, outflow tract diameter, and fractional RV area change were measured in all subjects. Peak RV systolic velocity (6.4 ± 2.2 vs 9 ± 1.6 cm/s, p <0.0001), early diastolic velocity (-6.7 ± 2.7 vs -9.4 ± 2 cm/s, p <0.0001), displacement (13.7 ± 5.8 vs 18.7 ± 3.5 mm, p <0.0003), strain rate (-1 ± 0.7 vs -2 ± 1 s-1, p = 0.002), and strain (-10 ± 6% vs -28 ± 11%, p = 0.001) were significantly lower in patients with ARVD compared with controls, respectively. Sensitivity and specificity, respectively, were 67% and 89% for systolic velocity, 77% and 71% for displacement, 73% and 87% for strain, 50% and 96% for strain rate, 53% and 93% for outflow tract diameter, and 47% and 83% for fractional area change. RV systolic velocity and displacement were significantly lower than in controls, even in the subset of patients with ARVD with apparently normal right ventricles by conventional echocardiography. Inter- and intraobserver agreement was high. In conclusion, TDE and SE enable the detection of ARVD via the quantification of RV function and may have potential clinical value in the assessment of patients with suspected ARVD. Peak RV systolic velocity <7.5 cm/s and peak RV strain <18% best identify patients with ARVD.
UR - http://www.scopus.com/inward/record.url?scp=34547136710&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34547136710&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2007.03.053
DO - 10.1016/j.amjcard.2007.03.053
M3 - Article
C2 - 17659937
AN - SCOPUS:34547136710
SN - 0002-9149
VL - 100
SP - 507
EP - 512
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 3
ER -