BIVENTRICULAR INVOLVEMENT IN ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY | Czech Cardiovascular Research and Innovation Days 2023

Background:Despite Arrhythmogenic right ventricular cardiomyopathy (ARVC) being a predominant right ventricle (RV) disease, concomitant left ventricle (LV) involvement has been recognized. Diagnosis is made through the 2010 Task force criteria (TFC), which are RV-centric, and has yet to include strain measurement. Our aim was to assess the utility of global longitudinal strain (GLS) of RV and LV for risk stratification of these patients.
Methods:
204 patients who met the TFC for the ARVC spectrum were included. Patients were categorized based on a cut-off of GLS -18% for impairment in both ventricles. Outcome was a composite of all-cause mortality, arrhythmic events, ICD therapy and heart failure.
Results:Patients (age 41 ± 17 years, 55% males) were divided into impaired, discordant (either RV or LV impaired), and normal strain groups. During a follow-up of 87 [24-136] months, 60 (29%) experienced the combined outcome, and a significant difference in event-free survival was observed (p<0.001) between the 3 groups (Fig). In the multivariate analysis, the GLS grouping remained associated with outcome (HR 2.398, 95% CI 1.065-5.395, p=0.040) after adjusting for age, gender, history of syncope and definite ARVC diagnosis. In a sub-analysis on definite and borderline ARVC patients, GLS grouping remained an independent predictor of events (p=0.027).
Conclusion: In ARVC patients, biventricular involvement by strain analysis has additional prognostic value, with outcomes differing if either the RV, LV or both are affected.

BIVENTRICULAR INVOLVEMENT IN ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY Topic: nezařazeno
Type: Presentation - doctors , Number in the programme: 63


Chua A.¹, Laenens D.², Sarrazyn C.³, Lopez - Santi M.⁴, Nabeta T.², Myagmardorj R.⁵, Bootsma M.⁶, Schaapveld D.⁶, Bax J.⁷, Marsan N.² ¹ Leiden University Medical Center, Leiden, Netherlands, ² Department of Cardilogy, Leiden University Medical Center, Leiden, Netherlands, ³ Ghent University, ⁴ National University of La Plata, ⁵ Department of Cardilogy, Heart Lung Centre, Leiden, Netherlands, ⁶ Leiden, Netherlands, ⁷ Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
Background:Despite Arrhythmogenic right ventricular cardiomyopathy (ARVC) being a predominant right ventricle (RV) disease, concomitant left ventricle (LV) involvement has been recognized. Diagnosis is made through the 2010 Task force criteria (TFC), which are RV-centric, and has yet to include strain measurement. Our aim was to assess the utility of global longitudinal strain (GLS) of RV and LV for risk stratification of these patients. Methods: 204 patients who met the TFC for the ARVC spectrum were included. Patients were categorized based on a cut-off of GLS -18% for impairment in both ventricles. Outcome was a composite of all-cause mortality, arrhythmic events, ICD therapy and heart failure. Results:Patients (age 41 ± 17 years, 55% males) were divided into impaired, discordant (either RV or LV impaired), and normal strain groups. During a follow-up of 87 [24-136] months, 60 (29%) experienced the combined outcome, and a significant difference in event-free survival was observed (p<0.001) between the 3 groups (Fig). In the multivariate analysis, the GLS grouping remained associated with outcome (HR 2.398, 95% CI 1.065-5.395, p=0.040) after adjusting for age, gender, history of syncope and definite ARVC diagnosis. In a sub-analysis on definite and borderline ARVC patients, GLS grouping remained an independent predictor of events (p=0.027). Conclusion: In ARVC patients, biventricular involvement by strain analysis has additional prognostic value, with outcomes differing if either the RV, LV or both are affected.

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