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Absolute measures of right ventricle, but not indexed values, are markers of ventricular arrhythmia in female arrhythmogenic cardiomyopathy patients

Session Poster session 4

Speaker Christine Rootwelt

Event : EuroEcho 2017

  • Topic : valvular, myocardial, pericardial, pulmonary, congenital heart disease
  • Sub-topic : Myocardial Disease - Clinical
  • Session type : Poster Session

Authors : C Rootwelt (Oslo,NO), OH Lie (Oslo,NO), LA Dejgaard (Oslo,NO), T Edvardsen (Oslo,NO), KH Haugaa (Oslo,NO)

Authors:
C Rootwelt1 , OH Lie1 , LA Dejgaard1 , T Edvardsen1 , KH Haugaa1 , 1Oslo University Hospital, Department of Cardiology, Rikshospitalet, and Center for Cardiological Innovation - Oslo - Norway ,

Citation:
European Heart Journal Supplements ( 2017 ) 18 ( Supplement 3 ), iii286

Background: Arrhythmogenic cardiomyopathy (AC) is an inheritable heart disease associated with high risk of life-threatening ventricular arrhythmias. Disease penetrance in AC is higher in men, and most studies on markers for ventricular arrhythmia include predominantly male subjects. Task Force Criteria of 2010 suggests indexing diameters by body surface area, but the applicability to female patients is not studied.

Purpose: To explore echocardiographic Task Force Criteria of 2010 parameters and their relation to ventricular arrhythmias in female AC patients.

Methods: We examined female AC patients by echocardiography. Right ventricular (RV) fractional area change (RV FAC) was measured, along with RV basal diameter (RVD) and RV outflow tract diameter (RVOT) which were reported as absolute and indexed values. We also assessed left ventricular ejection fraction (LVEF). Ventricular arrhythmia was defined as sustained ventricular tachycardia or fibrillation, aborted cardiac arrest or appropriate therapy from an implantable cardioverter-defibrillator.

Results: We included 79 female AC patients (42% probands, age 42±16 years), of which 26 (33%) had experienced ventricular arrhythmia (Table). RV FAC was worse in women with than without ventricular arrhythmia. RVOT and RVD were markers of ventricular arrhythmia only as absolute values. LVEF did not differ between the groups.

Conclusions: RV FAC and absolute RV dimensions were markers of ventricular arrhythmia, while indexed dimensions were not. Evaluation of female AC patients should not rely on indexed values established in predominantly male studies. Further studies on imaging markers in female AC patients are warranted.

No VA

n= 53

VA

n=26

p-value
RVD (mm) 36±5 45±9 <0.001
RVDi (mm/m2) 19±4 21±3 0.28
RVOT (mm) 31±5 36±9 0.01
RVOTi (mm/m2) 17±4 17±4 0.71
RV FAC (%) 46±7 35±9 <0.001
LV EF (%) 58±5 58±7 0.83
Values are mean ± SD, compared by Students t-test. LVEF = left ventricular ejection fraction, RV FAC = right ventricular fractional area change, RVDi = indexed right ventricular diameter, RVOTi = indexed right ventricular outflow tract diameter, VA = ventricular arrhythmia.

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