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Left Ventricular Involvement in Arrhythmogenic Right Ventricular Cardiomyopathy - A Cardiac Magnetic Resonance Imaging Study
並列摘要
Background: Few studies evaluated left ventricular (LV) involvement in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). The aim of this study is to determine the frequency, clinical presentation, and pattern of LV involvement in ARVD/C (LV-ARVD/C). Methods: We retrospectively evaluated the cardiac magnetic resonance (CMR) in 202 patients referred between 2008 and 2012 to our institution, and we determined the presence or the absence of CMR criteria in the revised task force criteria 2010 for the diagnosis of ARVD/C. A total of 21 patients were diagnosed with ARVD/C according to the revised task force criteria 2010. All included patients had no previous history of myocarditis, acute coronary syndrome, or any other cardiac disease that could interfere with the interpretations of structural abnormalities. The LV involvement in ARVD/C was defined by the presence of one or more of the following criteria: LV end-diastolic volume (LVEDV; ＞95 mL/m^2), LV ejection fraction (LVEF; ＜55%), LV late enhancement of gadolinium (LVLE) in a non-ischemic pattern, and LV wall motion abnormalities (WMAs). In the follow-up for the occurrence of cardiac death, ventricular tachycardia (VT) was obtained at a mean of 31 ± 20.6 months. Results : A total of 21 patients had ARVD/C. The median age was 48 (33-63) years. In all, 11 patients (52.4%) had LV-ARVD/C. The demographic characteristics of patients with or without LV were similar. There was a higher frequency of left bundle-branch block (LBBB) VT morphology in ARVD/C (P = 0.04). In CMR, regional WMAs of right ventricle (RV) and RV ejection fraction (RVEF; ＜45%) were strongly correlated with LV-WMAs (r = 0.72, P = 0.02, r = 0.75, P = 0.02, respectively). RV late enhancement of gadolinium (RVLE) was associated with LV-WMs and LVLE (r = 0.7, P = 0.03; r = 0.8, P = 0.006). LVLE was associated with LV-WMAs, LVEF, and LVEDV (r = 0.9, P = 0.001; r = 0.8, P = 0.001; r = 0.8, P = 0.01). Conclusion: LV involvement in ARVD/C is common and frequently associated with moderate to severe right ventricular (RV) abnormalities. The impact of LV involvement in ARVD/C on the prognosis needs further investigations.
延伸閱讀
- Looi, K. L., Edwards, C., Hart, H., & Christiansen, J. P. (2012). Utility of Cardiac Magnetic Resonance in the Evaluation of Unselected Patients with Possible Arrhythmogenic Right Ventricular Cardiomyopathy. Clinical Medicine Insights: Cardiology, 2012(), 153-162. https://doi.org/10.4137/CMC.S9996
- Chen, C. P., Huang, C. H., Lee, C. H., Wang, J. J., Chang, M. C., Yang, C. W., Hung, G. U., & Huang, W. S. (2014). TI-201 Myocardial SPECT is an Effective Imaging Modality for Differentiating Ischemic from Non-ischemic Dilated Cardiomyopathy in Patients with Left Ventricular Dysfunction. The Changhua Journal of Medicine, 12(1), 17-23. https://www.airitilibrary.com/Article/Detail?DocID=16801504-201403-201411060022-201411060022-17-23
- Menon, P. G., Adhypak, S. M., Williams, R. B., Doyle, M., & Biederman, R. W. W. (2014). Investigating Cardiac MRI Based Right Ventricular Contractility As A Novel Non-Invasive Metric of Pulmonary Arterial Pressure. Clinical Medicine Insights: Cardiology, 2014(S1), 45-50. https://doi.org/10.4137/CMC.S15711
- Lee, M. L., Liao, C. Y., Huang, S. C., Chiu, S. N., & Wang, J. K. (2018). Right Ventricular Cardiomyopathy in Repaired Tetralogy of Fallot: A Clinical Mimic of Arrhythmogenic Right Ventricular Cardiomyopathy. The Changhua Journal of Medicine, 16(3), 87-99. https://doi.org/10.6501/CJM.201809_16(3).0001
- Lin, Y. J., Chien, K. L., Chen, H. K., Wang, C. S., & Chu, C. C. (2015). Left Ventricular Dyssynchrony Predicts Left Main Coronary Artery Disease in Patients with Non-ST-Segment Elevation Myocardial Infarction. Acta Cardiologica Sinica, 31(3), 226-231. https://doi.org/10.6515/ACS20150105A