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Epicardial myocardial strain abnormalities may identify the earliest stages of arrhythmogenic cardiomyopathy.

Réant, P; Hauer, AD; Castelletti, S; Pantazis, A; Rosmini, S; Cheang, MH; Peyrou, J; ... McKenna, WJ; + view all (2016) Epicardial myocardial strain abnormalities may identify the earliest stages of arrhythmogenic cardiomyopathy. The International Journal of Cardiovascular Imaging , 32 (4) pp. 593-601. 10.1007/s10554-015-0813-9. Green open access

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Abstract

The aim of this cohort study was to evaluate the value of echocardiographic multilayer strain analysis in the identification of arrhythmogenic cardiomyopathy (AC) in its earliest stages in which sudden cardiac death can occurs. Twenty seven asymptomatic relatives of AC probands (mean age 39.6 ± 19.5 years, 37 % male) with a desmosomal pathogenic mutation but no additional criteria for AC (group II) were compared to age and sex-matched healthy controls (group I). In addition, 70 patients harboring a pathogenic desmosomal mutation with "definitive" diagnosis of AC (group IV), and 19 subjects with "borderline" diagnosis (group III) were also studied. A standard echocardiographic evaluation plus left (LV) and right ventricular global and regional transmural, endocardial, and epicardial longitudinal strain (LS) analysis, was performed. In group II, while LV ejection fraction, fractional shortening, and S' were not significantly reduced compared to controls, transmural global LS was significantly reduced to 19.3 ± 1.8 % in group II versus 20.9 ± 1.1 % in controls (p = 0.0003). Compared to controls, group II presented significant (p < 0.05) regional LS decrease in the basal infero-lateral, antero-lateral, latero-apical, infero-septal, and septo-apical segments. Moreover, LS of the latero-apical and the basal antero-lateral segments was significantly altered in the epicardium (p < 0.05) but not significantly in the endocardium. Global and regional LV LS analysis allows detection of AC in an early or non-diagnostic stage of the disease. Moreover, epicardial LS analysis allows the detection of abnormalities earlier than endocardial LS.

Type: Article
Title: Epicardial myocardial strain abnormalities may identify the earliest stages of arrhythmogenic cardiomyopathy.
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s10554-015-0813-9
Publisher version: http://dx.doi.org/10.1007/s10554-015-0813-9
Language: English
Additional information: Copyright The Author(s). All rights reserved. The final publication is available at Springer via http://dx.doi.org/10.1007/s10554-015-0813-9
Keywords: Arrhythmogenic cardiomyopathy, Cardiac imaging, Echocardiography, Myocardial strain, Speckle tracking
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
URI: https://discovery.ucl.ac.uk/id/eprint/1478252
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