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A meta-analysis for echocardiographic assessment of right ventricular structure and function in ARVC.

Qasem, M and Utomi, V and George, KP and Somauroo, J and Zaidi, A and Forsythe, L and Bhattacharrya, S and Lloyd, G and Rana, B and Ring, L and Robinson, S and Senior, R and Sheikh, N and Sitali, M and Sandoval, J and Steeds, R and Stout, M and Willis, J and Oxborough, D (2016) A meta-analysis for echocardiographic assessment of right ventricular structure and function in ARVC. Echo Research Practice, 3 (3). pp. 95-104. ISSN 2055-0464

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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  SD; 34 vs. 28 mm P<0.001) and RVDarea (23 vs. 18 cm2 P<0.001) compared to 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-1 P<0.001), E' (9 vs. 13 cm.s-1 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.

Item Type: Article
Subjects: Q Science > QP Physiology
R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: BioScientific
Related URLs:
Date Deposited: 22 Dec 2016 11:10
Last Modified: 07 Sep 2017 06:12
DOI or Identification number: 10.1530/ERP-16-0028
URI: http://researchonline.ljmu.ac.uk/id/eprint/4624

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