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Utility of Tissue Doppler and Strain Echocardiography in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
Arrhythmogenic right ventricular dysplasia (ARVD) is a heritable cardiomyopathy characterized by the fibrofatty replacement of right ventricular (RV) myocardium leading to RV failure and arrhythmias. This study evaluated the potential utility of tissue Doppler echocardiography (TDE) and strain echoc...
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Published in: | The American journal of cardiology 2007-08, Vol.100 (3), p.507-512 |
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creator | Prakasa, Kalpana R., MD Wang, Jianwen, MD Tandri, Harikrishna, MD Dalal, Darshan, MBBS Bomma, Chandra, MD Chojnowski, Roman, RDCS James, Cynthia, PhD Tichnell, Crystal, MGC Russell, Stuart, MD Judge, Daniel, MD Corretti, Mary, MD Bluemke, David, MD Calkins, Hugh, MD Abraham, Theodore P., MD |
description | Arrhythmogenic right ventricular dysplasia (ARVD) is a heritable cardiomyopathy characterized by the fibrofatty replacement of right ventricular (RV) myocardium leading to RV failure and arrhythmias. This study evaluated the potential utility of tissue Doppler echocardiography (TDE) and strain echocardiography (SE) to quantitatively assess RV function and their potential role in diagnosing ARVD. Images of 30 patients with ARVD (diagnosed by task force criteria) and 36 healthy controls were obtained. Peak systolic velocity, early diastolic velocity, displacement, strain rate, strain, outflow tract diameter, and fractional RV area change were measured in all subjects. Peak RV systolic velocity (6.4 ± 2.2 vs 9 ± 1.6 cm/s, p |
doi_str_mv | 10.1016/j.amjcard.2007.03.053 |
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This study evaluated the potential utility of tissue Doppler echocardiography (TDE) and strain echocardiography (SE) to quantitatively assess RV function and their potential role in diagnosing ARVD. Images of 30 patients with ARVD (diagnosed by task force criteria) and 36 healthy controls were obtained. Peak systolic velocity, early diastolic velocity, displacement, strain rate, strain, outflow tract diameter, and fractional RV area change were measured in all subjects. Peak RV systolic velocity (6.4 ± 2.2 vs 9 ± 1.6 cm/s, p <0.0001), early diastolic velocity (−6.7 ± 2.7 vs −9.4 ± 2 cm/s, p <0.0001), displacement (13.7 ± 5.8 vs 18.7 ± 3.5 mm, p <0.0003), strain rate (−1 ± 0.7 vs −2 ± 1 s−1 , p = 0.002), and strain (−10 ± 6% vs −28 ± 11%, p = 0.001) were significantly lower in patients with ARVD compared with controls, respectively. Sensitivity and specificity, respectively, were 67% and 89% for systolic velocity, 77% and 71% for displacement, 73% and 87% for strain, 50% and 96% for strain rate, 53% and 93% for outflow tract diameter, and 47% and 83% for fractional area change. RV systolic velocity and displacement were significantly lower than in controls, even in the subset of patients with ARVD with apparently normal right ventricles by conventional echocardiography. Inter- and intraobserver agreement was high. In conclusion, TDE and SE enable the detection of ARVD via the quantification of RV function and may have potential clinical value in the assessment of patients with suspected ARVD. Peak RV systolic velocity <7.5 cm/s and peak RV strain <18% best identify patients with ARVD.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2007.03.053</identifier><identifier>PMID: 17659937</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Arrhythmogenic Right Ventricular Dysplasia - diagnosis ; Arrhythmogenic Right Ventricular Dysplasia - diagnostic imaging ; Arrhythmogenic Right Ventricular Dysplasia - physiopathology ; Biological and medical sciences ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Cardiovascular system ; Coronary vessels ; Echocardiography ; Echocardiography, Doppler ; Electrocardiography ; Female ; Heart ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical diagnosis ; Medical sciences ; Observer Variation ; Sensitivity and Specificity ; Studies ; Ultrasonic imaging ; Ultrasonic investigative techniques ; Ventricular Function, Right</subject><ispartof>The American journal of cardiology, 2007-08, Vol.100 (3), p.507-512</ispartof><rights>Elsevier Inc.</rights><rights>2007 Elsevier Inc.</rights><rights>2007 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Aug 1, 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c541t-161275d5ba31993927e77e069c8429817123c180f91820d0d60f43841f0353ff3</citedby><cites>FETCH-LOGICAL-c541t-161275d5ba31993927e77e069c8429817123c180f91820d0d60f43841f0353ff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19218438$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17659937$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Prakasa, Kalpana R., MD</creatorcontrib><creatorcontrib>Wang, Jianwen, MD</creatorcontrib><creatorcontrib>Tandri, Harikrishna, MD</creatorcontrib><creatorcontrib>Dalal, Darshan, MBBS</creatorcontrib><creatorcontrib>Bomma, Chandra, MD</creatorcontrib><creatorcontrib>Chojnowski, Roman, RDCS</creatorcontrib><creatorcontrib>James, Cynthia, PhD</creatorcontrib><creatorcontrib>Tichnell, Crystal, MGC</creatorcontrib><creatorcontrib>Russell, Stuart, MD</creatorcontrib><creatorcontrib>Judge, Daniel, MD</creatorcontrib><creatorcontrib>Corretti, Mary, MD</creatorcontrib><creatorcontrib>Bluemke, David, MD</creatorcontrib><creatorcontrib>Calkins, Hugh, MD</creatorcontrib><creatorcontrib>Abraham, Theodore P., MD</creatorcontrib><title>Utility of Tissue Doppler and Strain Echocardiography in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Arrhythmogenic right ventricular dysplasia (ARVD) is a heritable cardiomyopathy characterized by the fibrofatty replacement of right ventricular (RV) myocardium leading to RV failure and arrhythmias. This study evaluated the potential utility of tissue Doppler echocardiography (TDE) and strain echocardiography (SE) to quantitatively assess RV function and their potential role in diagnosing ARVD. Images of 30 patients with ARVD (diagnosed by task force criteria) and 36 healthy controls were obtained. Peak systolic velocity, early diastolic velocity, displacement, strain rate, strain, outflow tract diameter, and fractional RV area change were measured in all subjects. Peak RV systolic velocity (6.4 ± 2.2 vs 9 ± 1.6 cm/s, p <0.0001), early diastolic velocity (−6.7 ± 2.7 vs −9.4 ± 2 cm/s, p <0.0001), displacement (13.7 ± 5.8 vs 18.7 ± 3.5 mm, p <0.0003), strain rate (−1 ± 0.7 vs −2 ± 1 s−1 , p = 0.002), and strain (−10 ± 6% vs −28 ± 11%, p = 0.001) were significantly lower in patients with ARVD compared with controls, respectively. Sensitivity and specificity, respectively, were 67% and 89% for systolic velocity, 77% and 71% for displacement, 73% and 87% for strain, 50% and 96% for strain rate, 53% and 93% for outflow tract diameter, and 47% and 83% for fractional area change. RV systolic velocity and displacement were significantly lower than in controls, even in the subset of patients with ARVD with apparently normal right ventricles by conventional echocardiography. Inter- and intraobserver agreement was high. In conclusion, TDE and SE enable the detection of ARVD via the quantification of RV function and may have potential clinical value in the assessment of patients with suspected ARVD. Peak RV systolic velocity <7.5 cm/s and peak RV strain <18% best identify patients with ARVD.</description><subject>Adult</subject><subject>Arrhythmogenic Right Ventricular Dysplasia - diagnosis</subject><subject>Arrhythmogenic Right Ventricular Dysplasia - diagnostic imaging</subject><subject>Arrhythmogenic Right Ventricular Dysplasia - physiopathology</subject><subject>Biological and medical sciences</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular system</subject><subject>Coronary vessels</subject><subject>Echocardiography</subject><subject>Echocardiography, Doppler</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical sciences</subject><subject>Observer Variation</subject><subject>Sensitivity and Specificity</subject><subject>Studies</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonic investigative techniques</subject><subject>Ventricular Function, Right</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><recordid>eNqFkk9v1DAQxSMEokvhI4AiJLhlO2MnsX0BVdvyR6qERFuulus4Gy9JHOwEKd--TjeiUi-cLFu_N34zb5LkLcIWAcuzw1Z1B618tSUAbAt0CwV9lmyQM5GhQPo82QAAyQTm4iR5FcIhXhGL8mVygqwshKBsk_jb0bZ2nFNXpzc2hMmkF24YWuNT1Vfp9eiV7dNL3bjlL-v2Xg3NnMa3c--beWw6tze91elPu2_G9JfpR2_11CqfXsxhaFWw6mz3IO1mN6ixmV8nL2rVBvNmPU-T2y-XN7tv2dWPr99351eZLnIcMyyRsKIq7hTF6FUQZhgzUArNcyI4MiRUI4daICdQQVVCnVOeYw20oHVNT5OPx7qDd38mE0bZ2aBN26reuClIBqzgBWcRfP8EPLjJ99GbJBQoo4TwCBVHSHsXgje1HLztlJ8lglwSkQe5JiKXRCRQGROJundr8emuM9Wjao0gAh9WQAWt2tqrXtvwyAmCPPYVuc9HzsSZ_bXGy6Ct6bWprDd6lJWz_7Xy6UkF3dqYnWp_m9mEf02jDESCvF7WZ9keYAA8Z5zeA5xgwH8</recordid><startdate>20070801</startdate><enddate>20070801</enddate><creator>Prakasa, Kalpana R., MD</creator><creator>Wang, Jianwen, MD</creator><creator>Tandri, Harikrishna, MD</creator><creator>Dalal, Darshan, MBBS</creator><creator>Bomma, Chandra, MD</creator><creator>Chojnowski, Roman, RDCS</creator><creator>James, Cynthia, PhD</creator><creator>Tichnell, Crystal, MGC</creator><creator>Russell, Stuart, MD</creator><creator>Judge, Daniel, MD</creator><creator>Corretti, Mary, MD</creator><creator>Bluemke, David, MD</creator><creator>Calkins, Hugh, MD</creator><creator>Abraham, Theodore P., MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20070801</creationdate><title>Utility of Tissue Doppler and Strain Echocardiography in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy</title><author>Prakasa, Kalpana R., MD ; Wang, Jianwen, MD ; Tandri, Harikrishna, MD ; Dalal, Darshan, MBBS ; Bomma, Chandra, MD ; Chojnowski, Roman, RDCS ; James, Cynthia, PhD ; Tichnell, Crystal, MGC ; Russell, Stuart, MD ; Judge, Daniel, MD ; Corretti, Mary, MD ; Bluemke, David, MD ; Calkins, Hugh, MD ; Abraham, Theodore P., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c541t-161275d5ba31993927e77e069c8429817123c180f91820d0d60f43841f0353ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Arrhythmogenic Right Ventricular Dysplasia - diagnosis</topic><topic>Arrhythmogenic Right Ventricular Dysplasia - diagnostic imaging</topic><topic>Arrhythmogenic Right Ventricular Dysplasia - physiopathology</topic><topic>Biological and medical sciences</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular system</topic><topic>Coronary vessels</topic><topic>Echocardiography</topic><topic>Echocardiography, Doppler</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medical sciences</topic><topic>Observer Variation</topic><topic>Sensitivity and Specificity</topic><topic>Studies</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonic investigative techniques</topic><topic>Ventricular Function, Right</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Prakasa, Kalpana R., MD</creatorcontrib><creatorcontrib>Wang, Jianwen, MD</creatorcontrib><creatorcontrib>Tandri, Harikrishna, MD</creatorcontrib><creatorcontrib>Dalal, Darshan, MBBS</creatorcontrib><creatorcontrib>Bomma, Chandra, MD</creatorcontrib><creatorcontrib>Chojnowski, Roman, RDCS</creatorcontrib><creatorcontrib>James, Cynthia, PhD</creatorcontrib><creatorcontrib>Tichnell, Crystal, MGC</creatorcontrib><creatorcontrib>Russell, Stuart, MD</creatorcontrib><creatorcontrib>Judge, Daniel, MD</creatorcontrib><creatorcontrib>Corretti, Mary, MD</creatorcontrib><creatorcontrib>Bluemke, David, MD</creatorcontrib><creatorcontrib>Calkins, Hugh, MD</creatorcontrib><creatorcontrib>Abraham, Theodore P., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Prakasa, Kalpana R., MD</au><au>Wang, Jianwen, MD</au><au>Tandri, Harikrishna, MD</au><au>Dalal, Darshan, MBBS</au><au>Bomma, Chandra, MD</au><au>Chojnowski, Roman, RDCS</au><au>James, Cynthia, PhD</au><au>Tichnell, Crystal, MGC</au><au>Russell, Stuart, MD</au><au>Judge, Daniel, MD</au><au>Corretti, Mary, MD</au><au>Bluemke, David, MD</au><au>Calkins, Hugh, MD</au><au>Abraham, Theodore P., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utility of Tissue Doppler and Strain Echocardiography in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2007-08-01</date><risdate>2007</risdate><volume>100</volume><issue>3</issue><spage>507</spage><epage>512</epage><pages>507-512</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Arrhythmogenic right ventricular dysplasia (ARVD) is a heritable cardiomyopathy characterized by the fibrofatty replacement of right ventricular (RV) myocardium leading to RV failure and arrhythmias. This study evaluated the potential utility of tissue Doppler echocardiography (TDE) and strain echocardiography (SE) to quantitatively assess RV function and their potential role in diagnosing ARVD. Images of 30 patients with ARVD (diagnosed by task force criteria) and 36 healthy controls were obtained. Peak systolic velocity, early diastolic velocity, displacement, strain rate, strain, outflow tract diameter, and fractional RV area change were measured in all subjects. Peak RV systolic velocity (6.4 ± 2.2 vs 9 ± 1.6 cm/s, p <0.0001), early diastolic velocity (−6.7 ± 2.7 vs −9.4 ± 2 cm/s, p <0.0001), displacement (13.7 ± 5.8 vs 18.7 ± 3.5 mm, p <0.0003), strain rate (−1 ± 0.7 vs −2 ± 1 s−1 , p = 0.002), and strain (−10 ± 6% vs −28 ± 11%, p = 0.001) were significantly lower in patients with ARVD compared with controls, respectively. Sensitivity and specificity, respectively, were 67% and 89% for systolic velocity, 77% and 71% for displacement, 73% and 87% for strain, 50% and 96% for strain rate, 53% and 93% for outflow tract diameter, and 47% and 83% for fractional area change. RV systolic velocity and displacement were significantly lower than in controls, even in the subset of patients with ARVD with apparently normal right ventricles by conventional echocardiography. Inter- and intraobserver agreement was high. In conclusion, TDE and SE enable the detection of ARVD via the quantification of RV function and may have potential clinical value in the assessment of patients with suspected ARVD. Peak RV systolic velocity <7.5 cm/s and peak RV strain <18% best identify patients with ARVD.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>17659937</pmid><doi>10.1016/j.amjcard.2007.03.053</doi><tpages>6</tpages></addata></record> |
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subjects | Adult Arrhythmogenic Right Ventricular Dysplasia - diagnosis Arrhythmogenic Right Ventricular Dysplasia - diagnostic imaging Arrhythmogenic Right Ventricular Dysplasia - physiopathology Biological and medical sciences Cardiac dysrhythmias Cardiology. Vascular system Cardiovascular Cardiovascular disease Cardiovascular system Coronary vessels Echocardiography Echocardiography, Doppler Electrocardiography Female Heart Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical diagnosis Medical sciences Observer Variation Sensitivity and Specificity Studies Ultrasonic imaging Ultrasonic investigative techniques Ventricular Function, Right |
title | Utility of Tissue Doppler and Strain Echocardiography in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy |
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