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01.12.2012 | Research | Ausgabe 1/2012 Open Access

Cardiovascular Ultrasound 1/2012

Evaluation of right and left ventricular function using speckle tracking echocardiography in patients with arrhythmogenic right ventricular cardiomyopathy and their first degree relatives

Zeitschrift:
Cardiovascular Ultrasound > Ausgabe 1/2012
Autoren:
Meriam Åström Aneq, Jan Engvall, Lars Brudin, Eva Nylander
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1476-7120-10-37) contains supplementary material, which is available to authorized users.

Competing interests

The authors have no competing interests.

Authors’ contributions

MÅA planned the study, investigated all patients, performed measurements and analyses and played a major part in the writing of the manuscript. EN took part in planning the study, reviewed and discussed the manuscript text. JE performed measurements and analyses and took part in writing and reviewing the manuscript. LB took part in the statistical analysis and reviewing the manuscript. All authors have read and approved the final manuscript.

Abstract

Introduction and aim

The identification of right ventricular abnormalities in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) in early stages is still difficult. The aim of this study was to investigate if longitudinal strain based on speckle tracking can detect subtle right (RV) or left ventricular (LV) dysfunction as an early sign of ARVC.

Methods and results

Seventeen male patients, fulfilling Task force criteria for ARVC, 49 (32–70) years old, nineteen male first degree relatives 29 (19–73) y.o. and twenty-two healthy male volunteers 36 (24–66) y.o participated in the study. Twelve-lead and signal-averaged electrocardiograms were recorded. All subjects underwent echocardiography. LV and RV diameters, peak systolic velocity from tissue Doppler and longitudinal strain based on speckle tracking were measured from the basal and mid segments in both ventricles. RV longitudinal strain measurement was successful in first degree relatives and controls (95 resp. 86%) but less feasible in patients (59%). Results were not systematically different between first degree relatives and controls. Using discriminant analysis, we then developed an index based on echocardiographic parameters. All normal controls had an index < l while patients with abnormal ventricles had an index between 1–4. Some of the first degree relatives deviated from the normal pattern.

Conclusion

Longitudinal strain of LV and RV segments was significantly lower in patients than in relatives and controls. An index was developed incorporating dimensional and functional echocardiographic parameters. In combination with genetic testing this index might help to detect early phenotype expression in mutation carriers.
Zusatzmaterial
Authors’ original file for figure 1
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Authors’ original file for figure 2
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Authors’ original file for figure 3
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Literatur
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