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3D right ventricular ejection fraction and longitudinal strain are independent predictors of major adverse cardiovascular events in patients with rrhythmogenic right ventricular cardiomyopathy

Session Echocardiography ePosters

Speaker Assistant Professor Leila Hosseini

Event : ESC Congress 2020

  • Topic : imaging
  • Sub-topic : 3D Echocardiography
  • Session type : ePosters

Authors : L Hosseini (Tehran,IR), A Sadeghpour (Tehran,IR), M Maleki (Tehran,IR), A Alizadehasl (Tehran,IR), N Rezaeian (Tehran,IR), F Zadehbagheri (Tehran,IR), H Bakhshandeh (Tehran,IR), S Hosseini (Tehran,IR)

L Hosseini1 , A Sadeghpour1 , M Maleki1 , A Alizadehasl1 , N Rezaeian1 , F Zadehbagheri1 , H Bakhshandeh1 , S Hosseini1 , 1Rajaie Cardiovascular Medical & Research Center - Tehran - Iran (Islamic Republic of) ,


Introduction: Evaluation of right ventricular (RV) function is essential in the follow up of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Role of advance echocardiography including 3D transthoracic echocardiography (3DTTE)  for evaluation of 3D  RV function and RV longitudinal strain in predicting prognosis in ARVC patients, has not been well investigated.

Purpose:  We aimed to evaluate 3DTTE parameters in predicting major advance cardiovascular events (MACE) defined as ventricular arrhythmia, cardiac hospitalization, heart transplantation, and death in ARVC patients.

Methods: Forty-eight definite ARVC subjects based on the 2010 Task force criteria were evaluated with standard 2D transthoracic echocardiography (2DTTE) and 3DTTE. Patients with poor image quality were excluded. RV function was evaluated by 2D and 3D TTE including: fractional area change (FAC), RV global and free wall longitudinal strain (RV2DGLS and RV2DFWLS) and 3D RV ejection fraction (RV3DEF), RV global and free wall longitudinal strain (RV3DGLS, and RV3DFWLS). The patients were followed up for a median period of 12 months (6-18 months) to record MACE.

Results: Forty-eight patients with mean age =38.5 ± 14 years; 79.2 % male, and mean RV3DEF =30.33%, were included. During the mean follow up 12 months, 12 patients (25%, with mean RV3DEF = 24.8 ± 9 %) experienced MACE whereas mean RV3EF in patient without any cardiovascular events during follow up was 34.21 ± 9%. The most common causes of hospitalization were arrhythmia, right-sided heart failure, and RV clot as the following: Ventricular arrhythmia in 7 patients (14.6%, with mean RV3DEF = 29.01 ± 8.82 %), RV clot in 2 cases (4.2%, with mean RV3DEF = 20.2 %), right-sided heart failure in 3 patients (6.3%, with mean RV3DEF = 16.83 ± 3.6 %) that 2 of them (2.1%, with mean RV3DEF = 14.58 ± 0.63) underwent heart transplantation.

Logistic regression analysis revealed RV3DTTE (p-value= 0.03, OR = 0.90, CI = 0.82-0.99), RV3DGLS (p-value= 0.05, OR = 1.27, CI = 0.99 - 1.61) and RV3DFWLS (p-value= 0.01, OR = 1.29, CI = 1.05 – 1.59), predicted cardiac adverse events, but there were no significant association between RV2DGLS, RV2DEWLS and FAC with MACE.

Conclusion: RV3DEF, RV3DGLS, and RV3DFWLS were powerful predictors of morbidity and mortality and can be useful as a valuable method in the prediction of major cardiovascular complications in ARVC patients.

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