Key result
Gene mutation carriers with ARVC had a significantly higher prevalence of right atrial dilation compared to noncarriers (54.7% vs. 27.8%, P=0.009), though genotype did not predict incident atrial involvement.
Why the study?
Does genotype predict atrial involvement in patients with arrhythmogenic right ventricular cardiomyopathy?
Cohort (n=100)
Does genotype predict atrial involvement in patients with arrhythmogenic right ventricular cardiomyopathy?
Atrial involvement is common in ARVC and is driven by hemodynamic factors such as tricuspid regurgitation and decreased LVEF rather than underlying genotype.
Genotype may shape atrial volumes and arrhythmias in ARVC; leaves open whether genotype-guided monitoring improves risk stratification.
BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heritable myocardium disorder that predominantly affects the ventricle. Little is known about atrial involvement. This study aimed to assess atrial involvement, especially the role of genotype on atrium in ARVC. METHODS: The incidence, characterization and predictors of atrial involvement were investigated. Nine known ARVC-causing genes were screened and the correlation between genotype and atrial involvement was assessed. RESULTS: Right atrium (RA) dilation, left atrium (LA) dilation, and sustained atrial tachyarrhythmias (ATa) were found in 45, 16 and 3 patients, respectively. Gene mutations were identified in 64 (64.0%) patients. Mutation carriers showed more RA dilation than noncarriers (54.7% vs. 27.8%, P = 0.009), and no difference in LA dilation and ATa. Multivariate analysis showed tricuspid regurgitation (OR: 18.867; 95% CI: 1.466-250.000; P = 0.024) increased the risk of RA dilation and decreased left ventricular ejection fraction (LVEF) (OR: 1.134; 95% CI: 1.002-1.272; P = 0.031) correlated with LA dilation, whereas genotype showed no significant effect. At a median follow-up time of 91 months, 7 patients died and 1 patient accepted heart transplantation. New-onset RA dilation, LA dilation, and sustained ATa were found in 8, 7, and 6 patients, respectively. Atrial involvement was not associated with the long-term survival. Despite mutation carriers showing more RA dilation, Kaplan-Meier analysis showed genotype was not associated with atrial involvement. CONCLUSION: Atrial involvement was common in ARVC. Tricuspid regurgitation and decreased LVEF increased the risk for atrial dilation. Genotype was not associated with atrial involvement.
No takes yet. Share an insight, caveat, or question.
Wu et al. (2018) conducted a cohort in Arrhythmogenic right ventricular cardiomyopathy (ARVC) (n=100). Gene mutation carrier status vs. Noncarriers was evaluated on Right atrium (RA) dilation (p=0.009). Gene mutation carriers with ARVC had a significantly higher prevalence of right atrial dilation compared to noncarriers (54.7% vs. 27.8%, P=0.009), though genotype did not predict incident atrial involvement.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: