engleski

Right ventricular fractional area changes calculated via CMRI may differentiate definite from borderline ARVC

Objectives: Evaluation of right ventricular morphology and function via cardiac magnetic resonance imaging (CMRI) is essential for establishing the diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC). Using the major and minor Revised Task Force Criteria scoring system, we can differentiate between definite, borderline and possible ARVC. In conjunction with ejection fraction (EF) and right ventricular (RV) volume measurements, RV fraction area change (RVFAC) is a valuable additional method for assessing RV function. The aim of this study was to evaluate whether RVFAC calculated via CMRI may differentiate between definite ARVC and borderline ARVC. Methods: 14 patients with suspected ARVC underwent CMRI performed with a 1.5 T MR system (Magnetom Avanto, Siemens). The 4- chamber and short axis cardiac views were obtained using cine imaging. A stack of short axis cine imaging slices was acquired from the RV base to the apex. For RV EF (RVEF) calculation, the end systolic and end diastolic areas were manually traced in the short axis. The RV end-diastolic area (RVEDA cm2) and RV end-systolic area (cm2) were calculated in the 4-chamber view, and the RVFAC was calculated via the formula RVFAC = 100 x (RVEDA -RV end-systolic area)/RVEDA. Results: Based on the aforementioned Revised Task Force Criteria, the patients were divided into a definite ARVC group (n=7) and a borderline ARVC group (n=7). Compared with the borderline group, patients with definite ARVC exhibited significantly lower RVEF (mean 33.4% 6 5.4, 95% CI 29.1–37.8 vs. mean 44.3% 6 5.2, 95% CI 40.0–48.6, p=0.0023), and lower RVFAC (mean 28.6% 6 5.8, 95% CI 22.8–34.4 vs. mean 44.9 6 8.1, 95% CI 39.1–50.6, p=0.0010). RVFAC was positively correlated with RVEF (p<0.00001, r=0.9455). Conclusion: CMRI is a valuable imaging modality for the assessment of RV function and confirmation of ARVC diagnoses. Our data suggest that RVFAC measurements can be useful for differentiating between definite and borderline ARVC, and that together with EF and RV volume, they should also be taken into account for the assessment of RV function via CMRI.

cardiac magnetic resonance imaging ; fraction area change ; arrhythmogenic right ventricular cardiomyopathy

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