Right atrial strain and cardiovascular outcome in arrhythmogenic right ventricular cardiomyopathy

Anwer, Shehab; Guastafierro, Francesca; Erhart, Ladina; Costa, Sarah; Akdiş, Deniz; Schuermann, Manuel; Hosseini, Seyed Hossein; Winkler, Neria E; Kuzo, Nazar; Gasperetti, Alessio; Brunckhorst, Corinna; Duru, Fırat; Saguner, Ardan M.; Tanner, Felix C.

doi:10.1093/ehjci/jeac070

Cited by 14 publications

(15 citation statements)

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“…Consistent with these studies, participants with RV dilatation, reduced RV function, and LV involvement had a higher possibility of reaching the endpoint in our population. Furthermore, the present study assessed RA deformation and provided evidence that RA reservoir and booster strain and 5-year risk score were strong independent predictors of adverse cardiac events at long-term follow-up, which was in line with previous studies [ 14 , 16 , 27 ]. The 5-year ARVC risk score, RV GLS, and LV involvement are all strongly associated with cardiac events in ARVC [ 21 , 24 , 27 ], while the results of the statistical selection algorithm indicated that RA reservoir strain and booster strain provide additional prognostic information in ARVC beyond RV GLS and LV involvement.…”

Section: Discussionsupporting

confidence: 91%

“…According to a large cohort study, RAEF and RA conduit strain rate were recognized as predictors of atrial arrhythmias in ARVC patients during long-term follow-up [ 15 ]. In their single-center retrospective design, Anwer et al [ 16 ] explored the prognostic significance of RA strain in ARVC using speckle-tracking echocardiographic, finding that RA reservoir and booster strain were related to adverse cardiovascular outcomes at a 5-year follow-up. However, RA strain measurement by speckle tracking is limited by the low signal-to-noise ratio and the thin atrial wall.…”

Section: Discussionmentioning

confidence: 99%

“…In a prospective cohort study, RA strain in ARVC has been found to be responsible for atrial arrhythmias by CMR tissue tracking [ 14 ]. Likewise, a retrospective study based on a single-center cohort suggested RA strain impairment in ARVC patients was associated with an increased risk of cardiovascular events using speckle-tracking echocardiography [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic value of right atrial strains in arrhythmogenic right ventricular cardiomyopathy

Zheng,

Chen,

et al. 2024

Insights Imaging

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Objectives Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy characterized by progressive fibrofatty infiltration of atrial and ventricular myocardium resulting in adverse cardiac events. Atrial function has been increasingly recognized as prognostically important for cardiovascular disease. As the right atrial (RA) strain is a sensitive parameter to describe RA function, we aimed to analyze the prognostic value of the RA strain in ARVC. Methods RA strain parameters were derived from cardiac magnetic resonance (CMR) images of 105 participants with definite ARVC. The endpoint was defined as a combination of sudden cardiac death, survival cardiac arrest, and appropriate implantable cardioverter-defibrillator intervention. Cox regression and Kaplan–Meier survival analyses were performed to evaluate the association between RA strain parameters and endpoint. Concordance index (C index), net reclassification index (NRI), and integrated discrimination improvement (IDI) were calculated to assess the incremental value of RA strain in predicting the endpoint. Results After a median follow-up of 5 years, 36 (34.3%) reaching the endpoint displayed significantly reduced RA strain parameters. At Kaplan–Meier analysis, impaired RA reservoir (RARS) and booster strains (RABS) were associated with an increased risk of the endpoint. After adjusting for conventional risk factors, RARS (hazard ratio [HR], 0.956; p = 0.005) and RABS (HR, 0.906; p = 0.002) resulted as independent predictors for endpoint at Cox regression analyses. In addition, RARS and RABS improved prognostic value to clinical risk factors and CMR morphological and functional predictors (all p < 0.05). Conclusion RARS and RABS were independent predictors for adverse cardiac events, which could provide incremental prognostic value for conventional predictors in ARVC. Critical relevance statement We evaluated the prognostic value of right atrial strain in ARVC patients and suggested cardiologists consider RA strain as a predictive parameter when evaluating the long-term outcome of ARVC patients in order to formulate better clinical therapy. Key points • Patients with ARVC had significantly reduced RA strain and strain rates compared with healthy participants. • Participants with lower RA reservoir and booster stains were associated with a significantly higher risk of adverse cardiac events. • RA booster and reservoir strain provide incremental value to conventional parameters. Graphical Abstract

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic value of right atrial strains in arrhythmogenic right ventricular cardiomyopathy

Zheng,

Chen,

et al. 2024

Insights Imaging

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“…O strain do AD, obtido nas fases reservatório e bomba, está associado a um risco aumentado de eventos CV. 120 …”

Section: Strain Nas Cardiomiopatiasunclassified

“…RA strain, obtained during the reservoir and pump phases, is associated with a greater risk of cardiovascular events. 120 …”

Section: Strain In Cardiomyopathiesmentioning

confidence: 99%

Posicionamento do Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia sobre o Uso do Strain Miocárdico na Rotina do Cardiologista – 2023

Almeida,

Melo,

Bihan

et al. 2023

Arquivos Brasileiros De Cardiologia

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Right Ventricular Function in Takayasu's Arteritis Patients With Pulmonary Artery Involvement Using MRI Feature Tracking

Li,

Liao,

Ren

et al. 2023

Magnetic Resonance Imaging

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BackgroundPulmonary artery involvement (PAI) is not rare in Takayasu arteritis (TA). Persistently elevated pulmonary arterial pressure in TA‐PAI patients leads to pulmonary hypertension (PH), and eventually cardiac death. Thus, the early detection of right ventricular dysfunction before the onset of PH is important.PurposeTo explore the potential of right ventricular global peak longitudinal and circumferential strain (RVGLS and RVGCS, respectively) in detecting right ventricular myocardial damage in TA‐PAI patients without PH.Study TypeRetrospective.PopulationOne hundred and six TA patients (39.6 ± 13.9 years), of whom 52 were non‐PAI and 54 were PAI patients (36 without PH and 18 with PH), along with 58 sex‐ and age‐matched healthy volunteers (HVs) (36.7 ± 13.2 years). The involved arteries were validated by aorta magnetic resonance (MR) angiography and pulmonary artery computed tomography angiography.Field Strength/Sequence3 T/Cine imaging sequence with a steady‐state free precession readout.AssessmentCardiac MRI‐derived parameters measured by two radiologists independently were compared among HVs, and TA patients with and without PAI. In addition, these indices were further compared among HVs, and TA‐PAI patients with and without PH.Statistical TestsStudent's t test, one‐way ANOVA analysis, Pearson and Spearman correlation analysis, and reproducibility analysis. A P‐value of <0.05 was considered statistically significant.ResultsAlthough the TA‐PAI patients without PH had a similar RV ejection fraction (RVEF) with HV (P = 0.348), RVGLS (non‐PH 20.6 ± 3.7% vs. HV 24.0 ± 3.1%) was significantly lower and RVGCS (non‐PH 14.8 ± 3.9% vs. HV 13.0 ± 2.7%) higher. The TA‐PAI patients with PH had significantly poorer RVGLS (PH 13.5 ± 3.8% vs. non‐PH 20.6 ± 3.7%) and RVGCS (PH 10.9 ± 3.2% vs. non‐PH 14.8 ± 3.9%) than those without PH.Data ConclusionRight ventricular dysfunction was detected in the TA‐PAI patients without PH. MR‐feature tracking may be an effective method for detecting early cardiac damage in the TA‐PAI patients without PH.Level of Evidence3Technical EfficacyStage 3

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Right atrial strain and cardiovascular outcome in arrhythmogenic right ventricular cardiomyopathy

Cited by 14 publications

References 34 publications

Prognostic value of right atrial strains in arrhythmogenic right ventricular cardiomyopathy

Prognostic value of right atrial strains in arrhythmogenic right ventricular cardiomyopathy

Posicionamento do Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia sobre o Uso do Strain Miocárdico na Rotina do Cardiologista – 2023

Right Ventricular Function in Takayasu's Arteritis Patients With Pulmonary Artery Involvement Using MRI Feature Tracking

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