Key result
Right ventricular 2D and 3D longitudinal strain parameters significantly correlated with electrical progression (e.g., RV 3D free-wall strain ρ = 0.65, P = .003) in patients with ARVC.
Why the study?
Arrhythmogenic RV cardiomyopathy is progressive, but the value of echocardiographic RV deformation parameters in predicting electrical progression remained to be determined.
Do echocardiographic right ventricular deformation parameters predict electrical progression in patients with arrhythmogenic right ventricular cardiomyopathy?
Cohort (n=40)
Do echocardiographic right ventricular deformation parameters predict electrical progression in patients with arrhythmogenic right ventricular cardiomyopathy?
Right ventricular 2D and 3D strain echocardiography parameters can predict electrical progression in patients with arrhythmogenic right ventricular cardiomyopathy and an ICD.
Answers are grounded in this paper and cite their sources.
RV deformation parameters may help monitor ARVC electrical progression; hypothesis-generating and requires prospective validation before guiding device management.
BACKGROUND: Arrhythmogenic right ventricular (RV) cardiomyopathy is a progressive disease characterized by the replacement of the normal myocardium with fibrofatty tissue. This study aimed to determine the value of echocardiographic RV deformation parameters in predicting electrical progression as assessed by serial changes in RV lead sensing and threshold in patients with arrhythmogenic RV cardiomyopathy. METHODS: The present study recruited 40 patients with a definitive diagnosis of arrhythmogenic RV cardiomyopathy at a mean (SD) age of 38.6 (14.2) years between 2018 and 2020. All patients had received an implantable cardioverter-defibrillator for the primary or secondary prevention of sudden cardiac death. The patients underwent 2-dimensional (2D) and 3-dimensional (3D) transthoracic echocardiographic examinations and RV 2D and 3D strain analyses, comprising free-wall longitudinal strain, global longitudinal strain, and strain rate. They were then followed up for electrical progression. RESULTS: During a mean (SD) follow-up period of 20 (6) months, the RV lead amplitude decreased from 7.95 (IQR, 4.53-10.25) mV to 5.25 (IQR, 2.88-8.55) mV (P < .001), and the lead threshold increased from 0.75 (IQR, 0.50-0.79) V to 0.75 (IQR, 0.75-1.00) V (P < .001). Right ventricular 2D free-wall (ρ = 0.56, P = .01), RV 2D global (ρ = 0.58, P = .007), and RV 3D free-wall (ρ = 0.65; P = .003) longitudinal strain correlated with electrical progression. CONCLUSION: Right ventricular 2D and 3D deformation parameters were found to be significant predictors of electrical progression during follow-up of patients with arrhythmogenic RV cardiomyopathy. These findings suggest that echocardiography has a pivotal role in predicting patients at high risk for electrical progression.
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Hosseini et al. (2023) conducted a cohort in Arrhythmogenic right ventricular cardiomyopathy (n=40). Echocardiographic RV deformation parameters (2D and 3D strain) was evaluated on Electrical progression (assessed by serial changes in RV lead sensing and threshold) (ρ = 0.65, p=.003). Right ventricular 2D and 3D longitudinal strain parameters significantly correlated with electrical progression (e.g., RV 3D free-wall strain ρ = 0.65, P = .003) in patients with ARVC.
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