A meta-analysis for the echocardiographic assessment of right ventricular structure and function in ARVC: a study by the research and audit committee of the British society of echocardiography

Mohammad Qasem, Richard Steeds, Victor Utomi, Keith George, John Somauroo, Abbas Zaidi, Lynsey Forsythe, Sanjeev Bhattacharrya, Guy Lloyd, Bushra Rana, Liam Ring, Shaun Robinson, Roxy Senior, Nabeel Sheikh, Mushemi Sitali, Julie Sandoval, Martin Stout, James Willis, David Oxborough

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)
155 Downloads (Pure)

Abstract

Introduction Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited pathology that can increase the risk of sudden death. Current task force criteria for echocardiographic diagnosis do not include new, regional assessment tools which may be relevant in a phenotypically diverse disease. We adopted a systematic review and meta-analysis approach to highlight echocardiographic indices that differentiated ARVC patients and healthy controls. Methods Data was extracted and analysed from prospective trials that employed a case–control design meeting strict inclusion and exclusion as well as a priori quality criteria. Structural indices included proximal RV outflow tract (RVOT1) and RV diastolic area (RVDarea). Functional indices included RV fractional area change (RVFAC), tricuspid annular systolic excursion (TAPSE), peak systolic and early diastolic myocardial velocities (S′ and E′, respectively) and myocardial strain. Results Patients with ARVC had larger RVOT1 (mean ± S.D.; 34 vs 28 mm, P < 0.001) and RVDarea (23 vs 18 cm2, P < 0.001) compared with healthy controls. ARVC patients also had lower RVFAC (38 vs 46%, P < 0.001), TAPSE (17 vs 23 mm, P < 0.001), S′ (9 vs 12 cm/s, P < 0.001), E′ (9 vs 13 cm/s, P < 0.001) and myocardial strain (−17 vs −30%, P < 0.001). Conclusion The data from this meta-analysis support current task force criteria for the diagnosis of ARVC. In addition, other RV measures that reflect the complex geometry and function in ARVC clearly differentiated between ARVC and healthy controls and may provide additional diagnostic and management value. We recommend that future working groups consider this data when proposing new/revised criteria for the echocardiographic diagnosis of ARVC.
Original languageEnglish
Pages (from-to)95-104
JournalEcho Research and Practice
Volume3
Issue number3
DOIs
Publication statusPublished - 29 Sept 2016

Keywords

  • echocardiography
  • arrhythmogenic right ventricular cardiomyopathy
  • ARVC

Fingerprint

Dive into the research topics of 'A meta-analysis for the echocardiographic assessment of right ventricular structure and function in ARVC: a study by the research and audit committee of the British society of echocardiography'. Together they form a unique fingerprint.

Cite this