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Left ventricular Myocardial dysfunction in arrhythmogenic cardiomyopathy with left ventricular involvement: A door to improving diagnosis.

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Left ventricular Myocardial dysfunction in arrhythmogenic cardiomyopathy with left ventricular involvement: A door to improving diagnosis.

dc.contributor.author	Vives-Gilabert, Yolanda
dc.contributor.author	Sanz-Sánchez, Jorge
dc.contributor.author	Molina Aguilar, Pilar
dc.contributor.author	Cebrián, Antonio
dc.contributor.author	Igual, Begoña
dc.contributor.author	Calvillo-Batllés, Pilar
dc.contributor.author	Domingo, Diana
dc.contributor.author	Millet, José
dc.contributor.author	Martínez-Dolz, Luis
dc.contributor.author	Castells, Francisco
dc.contributor.author	Zorio Grima, Esther
dc.date.accessioned	2021-04-19T07:28:22Z
dc.date.available	2021-04-19T07:28:22Z
dc.date.issued	2019
dc.identifier.citation	Vives-Gilabert, Yolanda Sanz-Sánchez, Jorge Molina Aguilar, Pilar Cebrián, Antonio Igual, Begoña Calvillo-Batllés, Pilar Domingo, Diana Millet, José Martínez-Dolz, Luis Castells, Francisco Zorio Grima, Esther 2019 Left ventricular Myocardial dysfunction in arrhythmogenic cardiomyopathy with left ventricular involvement: A door to improving diagnosis. International Journal of Cardiology
dc.identifier.uri	https://hdl.handle.net/10550/78748
dc.description.abstract	Background: Diagnostic Task Force Criteria (TFC) for arrhythmogenic cardiomyopathy (AC) exhibit poor performance for left dominant forms. TFC only include right ventricular (RV) dysfunction (akinesia, dyssynchrony, volumes and ejection fraction). Moreover, cardiac magnetic resonance imaging (CMRI) assessment of left ventricular (LV) dyssynchrony has hitherto not been described. Thus, we aimed to comprehensively characterize LV CMRI behavior in AC patients. Methods: Thirty-five AC patients with LV involvement and twenty-three non-affected family members (controls) were enrolled. Feature-tracking analysis was applied to cine CMRI to assess LV ejection fraction (LVEF), LV endsystolic and end-diastolic volume indexes, strain values and dyssynchrony. Regions with more frequent strain and dyssynchrony impairment were also studied. Results: Radial dyssynchrony and LVEF were selected (sensitivities 54.3% and 48.6%, respectively at 100% specificity), with a threshold of 70 ms for radial dyssynchrony and 48.5% for LVEF. 71.4% of patients exceeded these thresholds (31.4% both, 22.9% only dyssynchrony and 17.1% only LVEF). Considering these cut-off values as a novel combined criterion, 30% of patients with 'borderline' or 'possible' AC following 2010 TFC would move to a 'definite' AC diagnosis. Strain was globally impaired whereas dyssynchronous regions were more often apical and located at the inferolateral wall. Conclusions: Mirroring the RV evaluation, we suggest including LVEF and LV dyssynchrony to improve the diagnosis of AC. Two independent mechanisms can be claimed in AC patients with LV involvement: 1) decreased myocardial deformation with global LV affectation and 2) delayed myocardial contraction at localized regions.
dc.language.iso	eng
dc.relation.ispartof	International Journal of Cardiology, 2019
dc.subject	Patologia
dc.subject	Cor
dc.title	Left ventricular Myocardial dysfunction in arrhythmogenic cardiomyopathy with left ventricular involvement: A door to improving diagnosis.
dc.type	journal article	es_ES
dc.date.updated	2021-04-19T07:28:22Z
dc.identifier.idgrec	145251
dc.rights.accessRights	open access	es_ES