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Long-term follow-up in arrhythmogenic right ventricular cardiomyopathy using Tissue Doppler Imaging
Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
2008 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 42, no 6, 368-374 p.Article in journal (Refereed) Published
Abstract [en]

Aim: To study patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and describe different echocardiographic parameters and their change over time during almost 10 years follow-up period.

Methods: Fifteen patients (9 male, 6 female), aged 22-58 years (mean 40) with a diagnosis of ARVC, were followed up for a period of 6-10 years (mean 8.7). Twelve-lead and a signal- averaged ECG was recorded. Tricuspid and mitral annular motion and tissue Doppler imaging were registered by echocardiography. Wall motion score index (WMSI) was calculated for the left and right ventricles.

Results: We registered significant reduction in systolic tissue velocity on right ventricle free wall between the first and last investigations: 7-17cm/s (mean 11.8) to 4-15 (mean 9.1), p=0.005. WMSI increased by at least 0.2 in 10/14 patients for the right and in 8/15 patients for the left ventricle. A decrease in velocity time integral for the left ventricular outflow was observed (16-30 to 13-21, p=0.009).

Conclusion: ARVC is a progressive disease with individual variation. Left ventricular involvement may occur early in the disease. Tissue Doppler imaging is a useful tool to follow-up right ventricular abnormalities.

Place, publisher, year, edition, pages
2008. Vol. 42, no 6, 368-374 p.
Keyword [en]
Arrhythmogenic right ventricular cardiomyopathy, Doppler tissue imaging, progression, right ventricular function
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-16180DOI: 10.1080/14017430802372384OAI: oai:DiVA.org:liu-16180DiVA: diva2:133364
Available from: 2009-01-09 Created: 2009-01-09 Last updated: 2017-12-14
In thesis
1. Arrhythmogenic right ventricular cardiomyopathy: Is it right?
Open this publication in new window or tab >>Arrhythmogenic right ventricular cardiomyopathy: Is it right?
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart disease, where sudden cardiac death in young seemingly healthy persons may be the first symptom. There is a need for more sensitive and accurate diagnostic methods to detect signs of disease, at an early stage and in relatives of affected individuals. The aim of this thesis is the evaluation of new non-invasive modalities in assessment of right ventricular (RV) volume and function with focus on patients with ARVC.

Clinical and non-invasive follow-up of fifteen patients with ARVC during a mean period of 8 years permitted the evaluation of disease progression. RV volume analysis by magnetic resonance imaging relies on short axis (SA) views. A new axially rotated modality acquisition was tested and its feasibility in assessment of RV volume was evaluated. This acquisition seems to be able to improve the assessment of RV volume and function by reducing the uncertainty in defining the basal slice of the RV. A third study concentrated on analysis of RV regional and general function by echocardiography, using tissue Doppler imaging as well as two dimensional (2D) longitudinal strain based on speckle tracking in patients with ARVC, their first degree relatives and in healthy subjects. 2D strain showed a good feasibility in analysis of the RV function in relatives and controls but less in ARVC patients probably due to the progressive myocardial cell death with fibro-fatty replacement of the RV wall. In order to detect and follow up echocardiographic changes an index was developed combining dimensional and functional parameters for the left and for the right ventricle. Advances in the molecular genetics of ARVC have provided new insights into the understanding of the disease. Hitherto, 9 candidate genes have been identified. A new mutation in the plakophilin 2 gene was detected in a three generation family. The clinical phenotype related to this mutation was investigated.

The studies have evaluated and developed methods for studying the right ventricle with special emphasis on ARVC. With the ultimate goal of preventing sudden death in ARVC, a combination of genetic testing and improved diagnostic methods may create an improved algorithm for risk stratification and selection to prophylactic treatment.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 97 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1257
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-70403 (URN)978-91-7393-089-5 (ISBN)
Public defence
2011-10-07, Aulan, Hälsans Hus, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2011-09-06 Created: 2011-09-06 Last updated: 2011-09-08Bibliographically approved

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Åström Aneq, MeriamLindström, LenaNylander, Eva

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