Right Ventricular Wall Motion Abnormalities Found in Healthy Subjects by Cardiovascular Magnetic Resonance Imaging and Characterized with a New Segmental Model

Abstract

Right ventricular wall motion abnormalities are one of the criteria for the diagnosis of arrhythmogenic right ventricular cardiomyopathy. However, our findings indicate that they may also be seen around the insertion of the moderator band in healthy subjects, so that the significance of their presence at this site in patients undergoing diagnostic investigations for this disease should be interpreted with caution.

Cardiac MR Findings and Potential Diagnostic Pitfalls in Patients Evaluated for Arrhythmogenic Right Ventricular Cardiomyopathy

“…Frequent sites for regional RV wall motion abnormality in ARVC include the basal and mid segments of the free wall, the inferior wall, including the acute angle of the RV, and the RVOT (12) (Fig 1) (Movies 1, 2 [online]). However, the findings from studies performed by Sievers et al (39) and Fritz et al (40) showed a high prevalence of subjective regional RV wall motion abnormality at cardiac MR imaging in healthy volunteers. The most frequent site of apparent abnormality, which was seen in 79% of the healthy volunteers, was at the insertion site of the moderator band in the apicolateral wall (Fig 9) (Movie 5 [online]).…”

Imaging Study of Ventricular Scar in Arrhythmogenic Right Ventricular Cardiomyopathy

“…32 A CMR study demonstrated a 93.1% prevalence of RV wall motion abnormalities in healthy subjects, including areas of apparent dyskinesia (75.9%) and bulging (27.6%). 33 All these data indicate that conventional CMR may lead to misdiagnosis of ARVC by showing equivocal morphofunctional RV abnormalities. This is in keeping with our findings showing, at best, moderate agreement (Ͻ0.61) between abnormal wall motion areas and scars for all RV regions, when comparing wall motion abnormalities identified by cine-CMR with both DCE and EAS ( Figure 5).…”

Current and future role of echocardiography in arrhythmogenic right ventricular dysplasia/cardiomyopathy

“…www.cardiologyjournal.org around the moderator band insertions remains difficult by MRI [15,16]. Emerging new echocardiographic techniques, specifically three dimensional (3D) RV echocardiography and tissue deformation imaging, may increase the performance of echocardiography, overcoming the previously mentioned shortcoming of conventional RV echocardiography [17,18].…”