Diagnostic and Prognostic Value of Right Ventricular Fat Quantification from Computed Tomography in Arrhythmogenic Right Ventricular Cardiomyopathy
Faga, Valentina (Institut d'Investigació Biomèdica de Bellvitge)
Ruiz Cueto, María (Hospital Universitari de Bellvitge)
Viladés Medel, David (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Moreno Weidmann, Zoraida (Institut de Recerca Sant Pau)
Dallaglio, Paolo D. (Institut d'Investigació Biomèdica de Bellvitge)
Díez-López, Carles (Institut d'Investigació Biomèdica de Bellvitge)
Roura, Gerard (Institut d'Investigació Biomèdica de Bellvitge)
Guerra Ramos, José María (Universitat Autònoma de Barcelona. Facultat de Medicina)
Leta, Rubén (Hospital de la Creu Blanca)
Gómez-Hospital, Joan Antoni (Institut d'Investigació Biomèdica de Bellvitge)
Comín-Colet, Josep (Universitat de Barcelona)
Anguera, Ignasi (Institut d'Investigació Biomèdica de Bellvitge)
Di Marco, Andrea (Institut d'Investigació Biomèdica de Bellvitge)
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	Background: In arrhythmogenic right ventricular cardiomyopathy (ARVC) non-invasive scar evaluation is not included among the diagnostic criteria or the predictors of ventricular arrhythmias (VA) and sudden death (SD). Computed tomography (CT) has excellent spatial resolution and allows a clear distinction between myocardium and fat; thus, it has great potential for the evaluation of myocardial scar in ARVC. Objective: The objective of this study is to evaluate the feasibility, and the diagnostic and prognostic value of semi-automated quantification of right ventricular (RV) fat replacement from CT images. Methods: An observational case-control study was carried out including 23 patients with a definite (19) or borderline (4) ARVC diagnosis and 23 age- and sex-matched controls without structural heart disease. All patients underwent contrast-enhanced cardiac CT. RV images were semi-automatically reconstructed with the ADAS-3D software (ADAS3D Medical, Barcelona, Spain). A fibrofatty scar was defined as values of Hounsfield Units (HU) <-10. Within the scar, a border zone (between -10 HU and -50 HU) and dense scar (<-50 HU) were distinguished. Results: All ARVC patients had an RV scar and all scar-related measurements were significantly higher in ARVC cases than in controls (p < 0. 001). The total scar area and dense scar area showed no overlapping values between cases and controls, achieving perfect diagnostic performance (sensitivity and specificity of 100%). Among ARVC patients, 16 (70%) had experienced sustained VA or aborted SD. Among all clinical, ECG and imaging parameters, the dense scar area was the only one with a statistically significant association with VA and SD (p = 0. 003). Conclusions: In ARVC, RV myocardial fat quantification from CT is feasible and may have considerable diagnostic and prognostic value.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Arrhythmogenic right ventricular cardiomyopathy ; Cardiac computed tomography ; Myocardial fibrofatty replacement ; Sudden death ; Ventricular arrhythmias
Published in:	Journal of clinical medicine, Vol. 13 Núm. 13 (july 2024) , p. 3674, ISSN 2077-0383

DOI: 10.3390/jcm13133674
PMID: 38999240

16 p, 4.1 MB

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