Key result
Ebstein's anomaly was characterized by prevalent alterations in the short-axis direction, although 24% of healthy controls also exhibited reduced global radial and circumferential strain.
Why the study?
Ebstein's anomaly is a rare congenital heart disease affecting the global RV myocardium, and the study aimed to describe the complex contractile mechanics of the functional RV using CMR-FT.
Does cardiac magnetic resonance feature-tracking analysis detect early signs of right ventricular systolic impairment in unoperated Ebstein's anomaly compared to healthy controls?
Observational (n=75)
No
Does cardiac magnetic resonance feature-tracking analysis detect early signs of right ventricular systolic impairment in unoperated Ebstein's anomaly compared to healthy controls?
Answers are grounded in this paper and cite their sources.
CMR-FT can detect alterations in the short-axis direction (reduced GRS and GCS) of the functional right ventricle in Ebstein's anomaly, potentially serving as an early predictor of myocardial dysfunction prior to RVEF reduction.
Background: Cardiovascular magnetic resonance feature-tracking analysis (CMR-FT) provides a quantitative assessment of myocardial contraction with potential for diagnostic and prognostic ability in a wide spectrum of diseases. Ebstein's anomaly (EA) is a rare congenital heart disease characterized by apical displacement of the tricuspid valve. However, it is also considered a disorder of development affecting the global right ventricular myocardium. Aim of our study is to describe the complex contractile mechanics of the functional right ventricle (RV) in patients affected by EA through CMR-FT. Methods: Fifty surgery-free EA patients who had undergone a complete CMR protocol at our institution between January 2017 and December 2020 were selected for the retrospective study. A historical control group of twenty-five healthy subjects was also included. CMR-FT analysis was performed at a dedicated workstation by manually tracing RV endo- end epicardial borders on steady-state-free-precession (SSFP) cine images. Strain values were calculated. Apical displacement of the tricuspid valve (TV) was measured on a 4-chamber cine image from the right atrio-ventricular junction to the functional annulus of the TV. Results: 6 (24%) controls had reduced both GRS and GCS. Conclusions: The contractile pattern of the functional RV in EA is characterised by prevalent alterations in the short-axis direction as indicated by reduced GRS and GCS. Strain values might be reduced prior to routine used functional parameters like RV ejection fraction (RVEF) and can possibly serve as an early predictor of myocardial dysfunction in EA patients.
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Baessato et al. (2022) conducted an observational in Ebstein's anomaly (n=75). Ebstein's anomaly vs. Healthy subjects was evaluated on Reduced global radial strain (GRS) and global circumferential strain (GCS). Ebstein's anomaly was characterized by prevalent alterations in the short-axis direction, although 24% of healthy controls also exhibited reduced global radial and circumferential strain.
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