Davis M. Vigneault BS, Presenter: Nothing to Disclose

Anneline S. J. M. Te Riele MD, Abstract Co-Author: Nothing to Disclose

Cynthia James PhD, Abstract Co-Author: Nothing to Disclose

Stefan L. Zimmerman MD, Abstract Co-Author: Nothing to Disclose

Hugh Calkins, Abstract Co-Author: Nothing to Disclose

Harikrishna Tandri, Abstract Co-Author: Nothing to Disclose

David A. Bluemke MD, PhD, Abstract Co-Author: Research support, Siemens AG

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy characterized by regional wall motion abnormalities of the right ventricle (RV) that are often subtle and difficult to quantify. RV Myocardial strain is poorly assessed with tagged cardiac magnetic resonance (CMR) due to the thin RV wall. We sought to determine the feasibility of RV myocardial strain analysis in ARVC patients using a novel feature tracking method.

Patients with suspected ARVC and control subjects underwent horizontal long axis (HLA) and short axis (SA) cine imaging using SSFP sequences. In the HLA view, the RV was divided into subtricuspid (ST), anterior wall (AW), and apical (Ap) regions. In the SA view, the RV was divided into outflow tract (OT), free wall (FW), angle (Ang), and inferior (Inf) regions. Each region was analyzed to determine peak longitudinal and circumferential strain and strain-rate using Multimodality Tissue Tracking (MTT) software (MTT Version 6.0.4725, Toshiba Medical Systems Corporation, Tokyo, Japan).

58 subjects (19 controls, 20 preclinical ARVC [mutation+], and 19 overt ARVC [mutation+, Task Force+] patients) who had undergone cine CMR examination were enrolled in the study. The average age was 34.6 ± 16.2 years (40% women). Regional longitudinal strain and strain rate decreased in magnitude from control to preclinical to overt ARVC, though significance was only reached between overt and control (p < 0.01 for all strains / strain rates, with the exception of the apex). Strain was most abnormal in the subtricuspid region. Compared to longitudinal strain, circumferential strain and strain rate showed similar differences between groups, although more pronounced in the inferior region of the RV.

CMR feature tracking of the RV is feasible and may allow for quantification of regional wall motion abnormalities in ARVC.

Qualitative assessment of regional wall motion abnormalities is unreliable and subject to inter-observer variation. CMR feature tracking has the potential to improve the reliability of ARVC diagnosis and detection of regional wall motion abnormalities.

Vigneault, D, Te Riele, A, James, C, Zimmerman, S, Calkins, H, Tandri, H, Bluemke, D, Right Ventricular Strain Abnormalities in Arrhythmogenic Right Ventricular Cardiomyopathy: Analysis of CMR by Feature Tracking.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014651.html