HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: j.jacc.2006.07.045v1 48/10/2132    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (7) Citing Articles via Google Scholar Google Scholar Articles by Sen-Chowdhry, S. Articles by McKenna, W. J. Search for Related Content PubMed PubMed Citation Articles by Sen-Chowdhry, S. Articles by McKenna, W. J.

CLINICAL RESEARCH: ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY

Cardiovascular Magnetic Resonance in Arrhythmogenic Right Ventricular Cardiomyopathy Revisited

Comparison With Task Force Criteria and Genotype

Srijita Sen-Chowdhry, MA, MBBS, MRCP^_*,,_*, Sanjay K. Prasad, MD, MRCP, Petros Syrris, PhD^_*, Ricardo Wage, DCR(R), Deirdre Ward, MBBS, MRCPI^_*, Robert Merrifield, PhD, Gillian C. Smith, MSc, David N. Firmin, PhD, Dudley J. Pennell, MD, FACC and William J. McKenna, MD, DSc, FACC^_*

^_* Cardiology In The Young, The Heart Hospital, University College London, London, United Kingdom
Cardiovascular Magnetic Resonance Unit, National Heart and Lung Institute, Imperial College, London, United Kingdom
Wolfson Foundation Medical Image Computing Laboratory, Imperial College, London, United Kingdom

Manuscript received February 27, 2006; revised manuscript received July 12, 2006, accepted July 23, 2006.

^_* Reprint requests and correspondence: Dr. Srijita Sen-Chowdhry or Professor William J. McKenna, Cardiology In The Young, The Heart Hospital, 16–18 Westmoreland Street, London W1G 8PH, United Kingdom. (Email: srijita{at}doctors.org.uk).

OBJECTIVES: We sought to assess the utility of cardiovascular magnetic resonance (CMR) in the evaluation of arrhythmogenic right ventricular cardiomyopathy (ARVC) in relation to diagnostic criteria and genotype.

BACKGROUND: Timely diagnosis of ARVC is difficult as clinical findings may be subtle and nonspecific in early disease. The role of CMR is controversial owing to the absence of a standardized protocol, insufficient experience with the modality, and inherent difficulties in imaging the right ventricle.

METHODS: Comprehensive CMR examination was performed in 232 patients undergoing evaluation for suspected ARVC. CMR outcomes were compared with: 1) prospective clinical diagnosis using Task Force guidelines, with and without the proposed modifications for familial ARVC; and 2) gene-carrier status in 35 individuals from genotyped families.

RESULTS: CMR studies were positive in all 64 patients who prospectively fulfilled Task Force criteria, resulting in 100% sensitivity. Specificity in relation to Task Force criteria was low (29%). Of the 119 apparent false positives detected by CMR, however, 63 fulfilled modified diagnostic criteria for familial ARVC and 7 were obligate gene carriers, suggesting that CMR frequently identifies individuals with early disease, in whom Task Force criteria are relatively insensitive. This was borne out by evaluation of genotyped individuals (26 gene-positive and 9 gene-negative), in whom CMR had a sensitivity of 96% and a specificity of 78%.

CONCLUSIONS: CMR is a valuable component of the diagnostic workup for ARVC when performed with a dedicated protocol by specialists with experience in analysis of volumes, right ventricular wall motion, and delayed-enhancement imaging.

Abbreviations and Acronyms   ARVC = arrhythmogenic right ventricular cardiomyopathy   CMR = cardiovascular magnetic resonance   ECG = electrocardiogram   LE = late enhancement   LV = left ventricle/left ventricular   ROC = receiver-operating characteristic   RV = right ventricle/right ventricular   RWMA = regional wall motion abnormalities   SCD = sudden cardiac death   TF = Task Force

This article has been cited by other articles:

				T. Germans and A. C van Rossum The use of cardiac magnetic resonance imaging to determine the aetiology of left ventricular disease and cardiomyopathy Heart, April 1, 2008; 94(4): 510 - 518. [Full Text] [PDF]

				S. Sen-Chowdhry, P. Syrris, and W. J. McKenna Role of Genetic Analysis in the Management of Patients With Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy J. Am. Coll. Cardiol., November 6, 2007; 50(19): 1813 - 1821. [Abstract] [Full Text] [PDF]

				R. Nijveldt, A. M. Beek, T. Germans, O. Bondarenko, and A. C. van Rossum Arrhythmogenic right ventricular cardiomyopathy with evidence of biventricular involvement Can. Med. Assoc. J., June 19, 2007; 176(13): 1819 - 1821. [Full Text] [PDF]

				S. Sen-Chowdhry, P. Syrris, D. Ward, A. Asimaki, E. Sevdalis, and W. J. McKenna Clinical and Genetic Characterization of Families With Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Provides Novel Insights Into Patterns of Disease Expression Circulation, April 3, 2007; 115(13): 1710 - 1720. [Abstract] [Full Text] [PDF]