Background
Methods
Study population
CMR acquisition
FT-CMR software methods
Quantitative analysis
Myocardial strain analysis using FT-CMR
Global RV size and ejection fraction
Qualitative analysis
Feasibility
Reproducibility
Statistical analysis
Results
Baseline characteristics
OVERT ARVD/C (N = 39) | Preclinical ARVD/C (n = 40) | Controls (n = 31) | |
---|---|---|---|
Female (%) | 22 (56) | 18 (45) | 14 (45) |
Age (yrs) | 32.3 ± 13.5 | 31.3 ± 18.1 | 37.2 ± 14.9 |
Global CMR parameters | |||
RV EDV/BSA (mL/m2) | 88.3 ± 25.6a
| 68.4 ± 14.4 | 69.7 ± 12.9 |
RV ESV/BSA (mL/m2) | 47.4 ± 24.9a
| 31.1 ± 9.8 | 30.0 ± 8.6 |
RV EF (%) | 48.3 ± 11.7a
| 54.9 ± 9.6 | 56.9 ± 9.7 |
LV EDV/BSA (mL/m2) | 77.4 ± 12.1 | 69.1 ± 12.9 | 73.5 ± 9.6 |
LV ESV/BSA (mL/m2) | 30.6 ± 9.5 | 25.2 ± 7.0 | 30.9 ± 15.1 |
LV EF (%) | 62.7 ± 6.3 | 63.2 ± 11.7 | 58.9 ± 13.3 |
Clinical Phenotype | |||
Repolarization criteria | - | ||
Major | 36 (93) | 1 (3) | |
Minor | 22 (54) | 19 (48) | |
Depolarization criteria | - | ||
Major | 3 (8) | 0 (0) | |
Minor | 19 (49) | 18 (45) | |
Arrhythmia criteria | - | ||
Major | 7 (18) | 0 (0) | |
Minor | 26 (67) | 4 (10) | |
Structural criteria | - | ||
Major | 16 (41) | 0 (0) | |
Minor | 7 (18) | 0 (0) | |
TFC fulfillment: number of criteria (median) | 6 (IQR 5–7) | 2 (IQR 2–3) | - |
Feasibility comparison among software methods
FT-CMR intersoftware comparison of global and regional longitudinal strain
Global strain
Overt ARVD/C (N = 39) | Preclinical ARVD/C (N = 40) | Controls (N = 31) | P-Valuec
| |
---|---|---|---|---|
MEDIS | −17.6 ± 6.3ab
| −21.8 ± 4.6 | −21.4 ± 5.5 | 0.001 |
TOMTEC | −14.3 ± 7.1ab
| −17.7 ± 6.6 | −17.8 ± 5.6 | 0.057 |
MTT | −19.3 ± 6.2ab
| −26.2 ± 5.0 | −27.7 ± 5.5 | <0.001 |
CIRCLE | −21.3 ± 5.3 a
| −22.9 ± 3.7 | −23.7 ± 2.3 | 0.065 |
Regional strain
Overt ARVD/C (N = 39) | Preclinical ARVD/C (N = 40) | Controls (N = 31) | P-Valuec
| |
---|---|---|---|---|
Subtricuspid Region | ||||
MEDIS | −-28.4 ± 14.8a
| −31.6 ± 10.4a
| −38.1 ± 8.1 | 0.007 |
TOMTEC | −24.7 ± 18.3a
| −32.4 ± 12.6 | −34.3 ± 11.4 | 0.045 |
MTT | −24.4 ± 10.8ab
| −33.4 ± 10.9 | −36.9 ± 10.5 | <0.001 |
CIRCLE | −23.0 ± 8.4a
| −26.2 ± 6.3 | −27.0 ± 5.0 | 0.067 |
Anterior Wall Region | ||||
MEDIS | −20.6 ± 10.5ab
| −28.6 ± 10.3 | −29.0 ± 11.1 | 0.001 |
TOMTEC | −17.5 ± 11.9 | −19.7 ± 11.1 | −22.6 ± 12.5 | 0.248 |
MTT | −17.7 ± 6.4 ab
| −23.0 ± 6.1 | −22.8 ± 6.3 | 0.001 |
CIRCLE | −22.8 ± 6.2 | −24.2 ± 5.0 | −25.3 ± 3.4 | 0.168 |
Apical Region | ||||
MEDIS | −22.8 ± 10.0b
| −27.8 ± 8.7 | −25.1 ± 9.6 | 0.072 |
TOMTEC | −12.7 ± 10.7 | −14.7 ± 10.4 | −13.1 ± 8.6 | 0.674 |
MTT | −18.6 ± 8.8ab
| −23.3 ± 7.8 | −25.5 ± 9.6 | 0.019 |
CIRCLE | −18.3 ± 5.4 | −19.9 ± 5.1 | −19.5 ± 5.6 | 0.521 |
Reproducibility
Intra-Observer ICC | Inter-Observer ICC | |
---|---|---|
Subtricuspid Region | ||
MEDIS | 0.928 | 0.896 |
TOMTEC | 0.816 | 0.538 |
MTT | 0.696 | 0.519 |
CIRCLE | 0.980 | 0.719 |
Anterior Wall Region | ||
MEDIS | 0.954 | 0.792 |
TOMTEC | 0.699 | 0.864 |
MTT | 0.806 | 0.677 |
CIRCLE | 0.969 | 0.783 |
Apical Region | ||
MEDIS | 0.909 | 0.807 |
TOMTEC | 0.790 | 0.861 |
MTT | 0.787 | 0.472 |
CIRCLE | 0.944 | 0.577 |