Impact of revised Task Force Criteria: distinguishing the athlete’s heart from ARVC/D using cardiac magnetic resonance imaging

Background: Cardiac magnetic resonance (CMR) evaluation of athletes for arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is complicated by overlapping features such as right ventricular (RV) volume increase. The revised ARVC/D diagnostic Task Force Criteria (TFC) incorporate cut-of...

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Bibliographic Details
Published in:European journal of preventive cardiology 2012-08, Vol.19 (4), p.885-891
Main Authors: Luijkx, Tim, Velthuis, Birgitta K, Prakken, Niek HJ, Cox, Moniek GPJ, Bots, Michiel L, Mali, Willem PThM, Hauer, Richard NW, Cramer, Maarten J
Format: Article
Language:English
Subjects:
Adult
Analysis of Variance
Arrhythmogenic Right Ventricular Dysplasia - diagnosis
Arrhythmogenic Right Ventricular Dysplasia - pathology
Arrhythmogenic Right Ventricular Dysplasia - physiopathology
Cardiomegaly - diagnosis
Cardiomegaly - etiology
Cardiomegaly - pathology
Cardiomegaly - physiopathology
Cardiomegaly, Exercise-Induced
Case-Control Studies
Diagnosis, Differential
Female
Heart Ventricles - pathology
Heart Ventricles - physiopathology
Humans
Magnetic Resonance Imaging, Cine - standards
Male
Middle Aged
Netherlands
Practice Guidelines as Topic
Predictive Value of Tests
ROC Curve
Stroke Volume
Ventricular Function, Left
Ventricular Function, Right
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Summary:Background: Cardiac magnetic resonance (CMR) evaluation of athletes for arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is complicated by overlapping features such as right ventricular (RV) volume increase. The revised ARVC/D diagnostic Task Force Criteria (TFC) incorporate cut-off values for RV ejection fraction (EF) and RV end-diastolic volume (EDV) on CMR. Design: To distinguish ARVC/D patients from athletes we compared CMR ventricular volumes, function, TFC cut-off values, and LV/RV ratios since athletes show proportionate, and ARVC/D patients disproportionate, changes in LV and RV. Methods: Quantitative CMR parameters of 33 ARVC/D patients (64% male, mean age 45.4 years, diagnosed by revised TFC), 66 healthy athletes and 66 healthy non-athletes (sex and age matched) were compared using revised TFC and new cut-off values representing LV/RV balance. Results and conclusions: Absolute values for ARVC/D patients/athletes/non-athletes were: in males, RV EDV 149/133/106 ml/m2, ratio EDV LV/RV 0.70/0.91/0.93, RV EF 34/52/54%, LV EF 48/57/58%, ratio EF LV/RV 1.49/1.10/1.09; and in females, RV EDV 115/115/91 ml/m2, ratio EDV LV/RV 0.86/0.94/0.97, RV EF 43/54/58%, LV EF 52/57/61%, ratio EF LV/RV 1.23/1.08/1.04 (p-values 
ISSN:2047-4873
2047-4881
DOI:10.1177/1741826711414215