Key result
Patients with Brugada Syndrome exhibited significantly larger right ventricular outflow tract volumes (7.4 vs 5.8 mL/m2) and more frequent regional wall motion abnormalities (31% vs 0%) compared to healthy controls.
Why the study?
Do patients with Brugada Syndrome exhibit structural abnormalities in the right ventricular outflow tract compared to healthy controls and ARVC patients?
Observational (n=88)
Yes
Do patients with Brugada Syndrome exhibit structural abnormalities in the right ventricular outflow tract compared to healthy controls and ARVC patients?
Absolute Event Rate: 7.4% vs 5.8%
p-value: p=<0.0001
Brugada Syndrome is frequently associated with structural abnormalities localized to the right ventricular outflow tract, challenging the traditional view of it as a purely electrical disease without structural changes.
Challenges purely electrical view of Brugada Syndrome; observational data leaves open prognostic and therapeutic implications.
BACKGROUND: Increasing evidence suggests the presence of structural changes affecting the right ventricular outflow tract (RVOT) in patients with Brugada Syndrome (BrS). The aim of this study was to characterise the RV morphology in BrS and explore associations between morphologic, clinical, electrical, and genetic parameters using non-invasive multimodality testing. METHODS: Consecutive BrS patients (recruited 2013-2015) underwent clinical assessment, dedicated RV imaging using cardiac magnetic resonance (CMR) imaging (unless contra-indicated), electrical assessment (electrocardiogram, Holter monitoring, signal-averaged ECG[SAECG]) and genotyping. Morphologic data were compared to matched control and unmatched ARVC (arrhythmogenic right ventricular cardiomyopathy) cohorts, and potential associations between morphologic parameters and other variables were explored. RESULTS: BrS patients (n = 42, male 86%, age 46±12 years) exhibited normal global RV volume and function, comparable to control, in contrast to significantly larger, impaired RVs in ARVC cohort (RVESV p = 0.0001; RVEDV p<0.0001, RVEF p = 0.002). Compared with control, BrS patients exhibited larger RVOT volumes (7.4 ± 0.7 vs 5.8 ± 0.7 mL/m2, p<0.0001) and wall motion abnormalities (RWMA) (31% vs 0%, p = 0.005); compared with ARVC cohort, the RVOT volumes were similar (7.4 ± 0.7 vs, 8.1 ± 1.7, p = 0.52) and there were less RWMA (31% vs 76%, p = 0.01). Overall 67% BrS patients had abnormal RVOT morphology. Patients with abnormal RVOT tended to be older (48 ± 12 y vs 41 ± 12y, p = 0.06). Rare genetic variants were only observed in patients with abnormal RVOT morphology (36% vs 0%, p = 0.02). CONCLUSIONS: Patients with BrS frequently exhibit structural abnormalities localised to the RVOT and these changes may be age- and gene-dependent.
No takes yet. Share an insight, caveat, or question.
Gnanappa et al. (2018) conducted an observational in Brugada Syndrome (n=88). Brugada Syndrome vs. Healthy controls was evaluated on Indexed right ventricular outflow tract (RVOT) volume (mL/m2) (p=<0.0001). Patients with Brugada Syndrome exhibited significantly larger right ventricular outflow tract volumes (7.4 vs 5.8 mL/m2) and more frequent regional wall motion abnormalities (31% vs 0%) compared to healthy controls.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: