Key result
MRI parameter LRSL discriminates ARVC patients without major structural criteria from controls with 0.75 AUC.
Why the study?
To evaluate a cardiac MRI feature tracking-derived parameter combining right ventricular longitudinal and radial motions in detecting arrhythmogenic right ventricular cardiomyopathy.
Does a novel cardiac MRI feature tracking parameter (LRSL) improve the detection of arrhythmogenic right ventricular cardiomyopathy in patients without major structural abnormalities?
Case-Control (n=86)
Does a novel cardiac MRI feature tracking parameter (LRSL) improve the detection of arrhythmogenic right ventricular cardiomyopathy in patients without major structural abnormalities?
Effect estimate: AUC 0.75
Absolute Event Rate: 359.5% vs 618.6%
p-value: p=<.0001
A novel cardiac MRI parameter combining right ventricular longitudinal and radial motions (LRSL) demonstrates good diagnostic performance for detecting ARVC, even in patients lacking major structural abnormalities.
LRSL may aid ARVC detection without major criteria; leaves open prospective validation before clinical adoption.
Purpose To evaluate a cardiac MRI feature tracking (FT)–derived parameter that combines right ventricular (RV) longitudinal and radial motions in detecting arrhythmogenic right ventricular cardiomyopathy (ARVC). Materials and Methods Patients with ARVC (n = 47; median age, 46 [IQR, 30–52] years; 31 men) were compared with controls (n = 39; median age, 46 [IQR, 33–53] years; 23 men) and separated into two groups based on fulfillment of major structural 2020 International criteria. Cine data from 1.5-T cardiac MRI examinations were analyzed using FT, resulting in conventional strain parameters and a novel composite index named the longitudinal-to-radial strain loop (LRSL). Receiver operating characteristic (ROC) analysis was used to assess diagnostic performance of RV parameters. Results Volumetric parameters differed significantly between patients in the major structural criteria group and controls but not between patients in the no major structural criteria group and controls. Patients in the major structural criteria group had significantly lower magnitudes of all FT parameters than controls, including RV basal longitudinal strain, radial motion fraction, circumferential strain, and LRSL (-15.6% ± 6.4 vs -26.7% ± 13.9; -9.6% ± 4.89 vs -13.8% ± 4.7; -6.9% ± 4.6 vs -10.1% ± 3.8; and 217.0 ± 128.9 versus 618.6 ± 356.3, respectively). Only LRSL differed between patients in the no major structural criteria group and controls (359.5 ± 195.8 vs 618.6 ± 356.3; P < .0001). Parameters with the highest area under the ROC curve values for discriminating patients in the no major structural criteria group from controls were LRSL, RV ejection fraction, and RV basal longitudinal strain (0.75, 0.70, and 0.61, respectively). Conclusion A new parameter combining RV longitudinal and radial motions showed good diagnostic performance in ARVC, even in patients without major structural abnormalities. Keywords: Arrhythmogenic Right Ventricular Dysplasia, Strain, Wall Motion Abnormalities, Right Ventricle, MRI, Inherited Cardiomyopathy Supplemental material is available for this article.
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Laredo et al. (2023) conducted a case-control in Arrhythmogenic right ventricular cardiomyopathy (n=86). Longitudinal-to-radial strain loop (LRSL) via cardiac MRI feature tracking vs. Controls was evaluated on LRSL value in patients without major structural criteria versus controls (AUC 0.75, p=<.0001). The novel cardiac MRI parameter longitudinal-to-radial strain loop (LRSL) discriminated ARVC patients without major structural criteria from controls (AUC 0.75; P<0.0001).
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