Right Ventricular Strain and Dyssynchrony Assessment in Arrhythmogenic Right Ventricular Cardiomyopathy: Cardiac Magnetic Resonance Feature-Tracking Study

Giulio Prati, Giancarlo Vitrella, Giuseppe Allocca, Daniele Muser, Sonja Cukon Buttignoni, Gianluca Piccoli, Giorgio Morocutti, Pietro Delise, Bruno Pinamonti, Alessandro Proclemer, Gianfranco Sinagra, Gaetano Nucifora

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background-Analysis of right ventricular (RV) regional dysfunction by cardiac magnetic resonance (CMR) imaging in arrhythmogenic RV cardiomyopathy (ARVC) may be inadequate because of the complex contraction pattern of the RV. Aim of this study was to determine the use of RV strain and dyssynchrony assessment in ARVC using feature-tracking CMR analysis. Methods and Results-Thirty-two consecutive patients with ARVC referred to CMR imaging were included. Thirty-two patients with idiopathic RV outflow tract arrhythmias and 32 control subjects, matched for age and sex to the ARVC group, were included for comparison purpose. CMR imaging was performed to assess biventricular function; feature-tracking analysis was applied to the cine CMR images to assess regional and global longitudinal, circumferential, and radial RV strains and RV dyssynchrony (defined as the SD of the time-to-peak strain of the RV segments). RV global longitudinal strain (-17±5% versus-26±6% versus-29±6%; P<0.001), global circumferential strain (-9±4% versus-12±4% versus-13±5%; P=0.001), and global radial strain (18 [12-26]% versus 22 [15-32]% versus 27 [20-39]%; P=0.015) were significantly lower and SD of the time-to-peak RV strain in all 3 directions were significantly higher among patients with ARVC compared with patients with RV outflow tract arrhythmias and controls. RV global longitudinal strain >-23.2%, SD of the time-to-peak RV longitudinal strain >113.1 ms, and SD of the time-to-peak RV circumferential strain >177.1 ms allowed correct identification of 88%, 75%, and 63% of ARVC patients with no or only minor CMR criteria for ARVC diagnosis. Conclusions-Strain analysis by feature-tracking CMR helps to objectively quantify global and regional RV dysfunction and RV dyssynchrony in patients with ARVC and provides incremental value over conventional cine CMR imaging.

LanguageEnglish
JournalCirculation: Cardiovascular Imaging
Volume8
Issue number11
DOIs
Publication statusPublished - 1 Jan 2015

Keywords

  • arrhythmogenic right ventricular cardiomyopathy
  • magnetic resonance imaging
  • myocardium
  • strain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Prati, Giulio ; Vitrella, Giancarlo ; Allocca, Giuseppe ; Muser, Daniele ; Buttignoni, Sonja Cukon ; Piccoli, Gianluca ; Morocutti, Giorgio ; Delise, Pietro ; Pinamonti, Bruno ; Proclemer, Alessandro ; Sinagra, Gianfranco ; Nucifora, Gaetano. / Right Ventricular Strain and Dyssynchrony Assessment in Arrhythmogenic Right Ventricular Cardiomyopathy : Cardiac Magnetic Resonance Feature-Tracking Study. In: Circulation: Cardiovascular Imaging. 2015 ; Vol. 8, No. 11.
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abstract = "Background-Analysis of right ventricular (RV) regional dysfunction by cardiac magnetic resonance (CMR) imaging in arrhythmogenic RV cardiomyopathy (ARVC) may be inadequate because of the complex contraction pattern of the RV. Aim of this study was to determine the use of RV strain and dyssynchrony assessment in ARVC using feature-tracking CMR analysis. Methods and Results-Thirty-two consecutive patients with ARVC referred to CMR imaging were included. Thirty-two patients with idiopathic RV outflow tract arrhythmias and 32 control subjects, matched for age and sex to the ARVC group, were included for comparison purpose. CMR imaging was performed to assess biventricular function; feature-tracking analysis was applied to the cine CMR images to assess regional and global longitudinal, circumferential, and radial RV strains and RV dyssynchrony (defined as the SD of the time-to-peak strain of the RV segments). RV global longitudinal strain (-17±5{\%} versus-26±6{\%} versus-29±6{\%}; P<0.001), global circumferential strain (-9±4{\%} versus-12±4{\%} versus-13±5{\%}; P=0.001), and global radial strain (18 [12-26]{\%} versus 22 [15-32]{\%} versus 27 [20-39]{\%}; P=0.015) were significantly lower and SD of the time-to-peak RV strain in all 3 directions were significantly higher among patients with ARVC compared with patients with RV outflow tract arrhythmias and controls. RV global longitudinal strain >-23.2{\%}, SD of the time-to-peak RV longitudinal strain >113.1 ms, and SD of the time-to-peak RV circumferential strain >177.1 ms allowed correct identification of 88{\%}, 75{\%}, and 63{\%} of ARVC patients with no or only minor CMR criteria for ARVC diagnosis. Conclusions-Strain analysis by feature-tracking CMR helps to objectively quantify global and regional RV dysfunction and RV dyssynchrony in patients with ARVC and provides incremental value over conventional cine CMR imaging.",
keywords = "arrhythmogenic right ventricular cardiomyopathy, magnetic resonance imaging, myocardium, strain",
author = "Giulio Prati and Giancarlo Vitrella and Giuseppe Allocca and Daniele Muser and Buttignoni, {Sonja Cukon} and Gianluca Piccoli and Giorgio Morocutti and Pietro Delise and Bruno Pinamonti and Alessandro Proclemer and Gianfranco Sinagra and Gaetano Nucifora",
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Prati, G, Vitrella, G, Allocca, G, Muser, D, Buttignoni, SC, Piccoli, G, Morocutti, G, Delise, P, Pinamonti, B, Proclemer, A, Sinagra, G & Nucifora, G 2015, 'Right Ventricular Strain and Dyssynchrony Assessment in Arrhythmogenic Right Ventricular Cardiomyopathy: Cardiac Magnetic Resonance Feature-Tracking Study', Circulation: Cardiovascular Imaging, vol. 8, no. 11. https://doi.org/10.1161/CIRCIMAGING.115.003647

Right Ventricular Strain and Dyssynchrony Assessment in Arrhythmogenic Right Ventricular Cardiomyopathy : Cardiac Magnetic Resonance Feature-Tracking Study. / Prati, Giulio; Vitrella, Giancarlo; Allocca, Giuseppe; Muser, Daniele; Buttignoni, Sonja Cukon; Piccoli, Gianluca; Morocutti, Giorgio; Delise, Pietro; Pinamonti, Bruno; Proclemer, Alessandro; Sinagra, Gianfranco; Nucifora, Gaetano.

In: Circulation: Cardiovascular Imaging, Vol. 8, No. 11, 01.01.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Right Ventricular Strain and Dyssynchrony Assessment in Arrhythmogenic Right Ventricular Cardiomyopathy

T2 - Circulation: Cardiovascular Imaging

AU - Prati, Giulio

AU - Vitrella, Giancarlo

AU - Allocca, Giuseppe

AU - Muser, Daniele

AU - Buttignoni, Sonja Cukon

AU - Piccoli, Gianluca

AU - Morocutti, Giorgio

AU - Delise, Pietro

AU - Pinamonti, Bruno

AU - Proclemer, Alessandro

AU - Sinagra, Gianfranco

AU - Nucifora, Gaetano

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background-Analysis of right ventricular (RV) regional dysfunction by cardiac magnetic resonance (CMR) imaging in arrhythmogenic RV cardiomyopathy (ARVC) may be inadequate because of the complex contraction pattern of the RV. Aim of this study was to determine the use of RV strain and dyssynchrony assessment in ARVC using feature-tracking CMR analysis. Methods and Results-Thirty-two consecutive patients with ARVC referred to CMR imaging were included. Thirty-two patients with idiopathic RV outflow tract arrhythmias and 32 control subjects, matched for age and sex to the ARVC group, were included for comparison purpose. CMR imaging was performed to assess biventricular function; feature-tracking analysis was applied to the cine CMR images to assess regional and global longitudinal, circumferential, and radial RV strains and RV dyssynchrony (defined as the SD of the time-to-peak strain of the RV segments). RV global longitudinal strain (-17±5% versus-26±6% versus-29±6%; P<0.001), global circumferential strain (-9±4% versus-12±4% versus-13±5%; P=0.001), and global radial strain (18 [12-26]% versus 22 [15-32]% versus 27 [20-39]%; P=0.015) were significantly lower and SD of the time-to-peak RV strain in all 3 directions were significantly higher among patients with ARVC compared with patients with RV outflow tract arrhythmias and controls. RV global longitudinal strain >-23.2%, SD of the time-to-peak RV longitudinal strain >113.1 ms, and SD of the time-to-peak RV circumferential strain >177.1 ms allowed correct identification of 88%, 75%, and 63% of ARVC patients with no or only minor CMR criteria for ARVC diagnosis. Conclusions-Strain analysis by feature-tracking CMR helps to objectively quantify global and regional RV dysfunction and RV dyssynchrony in patients with ARVC and provides incremental value over conventional cine CMR imaging.

AB - Background-Analysis of right ventricular (RV) regional dysfunction by cardiac magnetic resonance (CMR) imaging in arrhythmogenic RV cardiomyopathy (ARVC) may be inadequate because of the complex contraction pattern of the RV. Aim of this study was to determine the use of RV strain and dyssynchrony assessment in ARVC using feature-tracking CMR analysis. Methods and Results-Thirty-two consecutive patients with ARVC referred to CMR imaging were included. Thirty-two patients with idiopathic RV outflow tract arrhythmias and 32 control subjects, matched for age and sex to the ARVC group, were included for comparison purpose. CMR imaging was performed to assess biventricular function; feature-tracking analysis was applied to the cine CMR images to assess regional and global longitudinal, circumferential, and radial RV strains and RV dyssynchrony (defined as the SD of the time-to-peak strain of the RV segments). RV global longitudinal strain (-17±5% versus-26±6% versus-29±6%; P<0.001), global circumferential strain (-9±4% versus-12±4% versus-13±5%; P=0.001), and global radial strain (18 [12-26]% versus 22 [15-32]% versus 27 [20-39]%; P=0.015) were significantly lower and SD of the time-to-peak RV strain in all 3 directions were significantly higher among patients with ARVC compared with patients with RV outflow tract arrhythmias and controls. RV global longitudinal strain >-23.2%, SD of the time-to-peak RV longitudinal strain >113.1 ms, and SD of the time-to-peak RV circumferential strain >177.1 ms allowed correct identification of 88%, 75%, and 63% of ARVC patients with no or only minor CMR criteria for ARVC diagnosis. Conclusions-Strain analysis by feature-tracking CMR helps to objectively quantify global and regional RV dysfunction and RV dyssynchrony in patients with ARVC and provides incremental value over conventional cine CMR imaging.

KW - arrhythmogenic right ventricular cardiomyopathy

KW - magnetic resonance imaging

KW - myocardium

KW - strain

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U2 - 10.1161/CIRCIMAGING.115.003647

DO - 10.1161/CIRCIMAGING.115.003647

M3 - Article

VL - 8

JO - Circulation: Cardiovascular Imaging

JF - Circulation: Cardiovascular Imaging

SN - 1941-9651

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