Dorobantu, DM, Riding, N, McClean, G, de la Garza, MS, Abuli-Lluch, M, Sharma, C, Duarte, N, Adamuz, MC, Watt, V, Hamilton, RM, Ryding, D, Perry, D, McNally, S, Stuart, AG, Sitges, M, Oxborough, DL, Wilson, M, Friedberg, MK, Williams, CA and Pieles, GE (2023) The use of 2-D speckle tracking echocardiography in differentiating healthy adolescent athletes with right ventricular outflow tract dilation from patients with arrhythmogenic cardiomyopathy. International Journal of Cardiology, 382. pp. 98-105. ISSN 0167-5273

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Abstract

Aims: Echocardiographic assessment of adolescent athletes for arrhythmogenic cardiomyopathy (ACM) can be challenging owing to right ventricular (RV) exercise-related remodelling, particularly RV outflow tract (RVOT) dilation. The aim of this study is to evaluate the role of RV 2-D speckle tracking echocardiography (STE) in comparing healthy adolescent athletes with and without RVOT dilation to patients with ACM. Methods and results: A total of 391 adolescent athletes, mean age 14.5 ± 1.7 years, evaluated at three sports academies between 2014 and 2019 were included, and compared to previously reported ACM patients (n = 38 definite and n = 39 borderline). Peak systolic RV free wall (RVFW-Sl), global and segmental strain (Sl), and corresponding strain rates (SRl) were calculated. The participants meeting the major modified Task Force Criteria (mTFC) for RVOT dilation were defined as mTFC+ (n = 58, 14.8%), and the rest as mTFC- (n = 333, 85.2%). Mean RVFW-Sl was −27.6 ± 3.4% overall, −28.2 ± 4.1% in the mTFC+ group and − 27.5 ± 3.3% in the mTFC- group. mTFC+ athletes had normal RV-FW-Sl when compared to definite (−29% vs −19%, p < 0.001) and borderline ACM (−29% vs −21%, p < 0.001) cohorts. In addition, all mean global and regional Sl and SRl values were no worse in the mTFC+ group compared to the mTFC- (p values range < 0.0001 to 0.1, inferiority margin of 2% and 0.1 s−1 respectively). Conclusions: In athletes with RVOT dilation meeting the major mTFC, STE evaluation of the RV can demostrate normal function and differentiate physiological remodelling from pathological changes found in ACM, improving screening in grey-area cases.

Item Type:	Article
Uncontrolled Keywords:	Humans; Arrhythmogenic Right Ventricular Dysplasia; Ventricular Dysfunction, Right; Echocardiography; Dilatation; Ventricular Function, Right; Ventricular Remodeling; Adolescent; Child; Athletes; Arrhythmogenic cardiomyopathy; Paediatric athlete; Preparticipation screening; Right ventricle longitudinal strain; Speckle tracking echocardiography; Humans; Adolescent; Child; Dilatation; Arrhythmogenic Right Ventricular Dysplasia; Ventricular Function, Right; Echocardiography; Athletes; Ventricular Remodeling; Ventricular Dysfunction, Right; 1102 Cardiorespiratory Medicine and Haematology; 1117 Public Health and Health Services; Cardiovascular System & Hematology
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport & Exercise Sciences
Publisher:	Elsevier BV
SWORD Depositor:	A Symplectic
Date Deposited:	21 Jul 2023 15:18
Last Modified:	21 Jul 2023 15:31
DOI or ID number:	10.1016/j.ijcard.2023.04.001
URI:	https://researchonline.ljmu.ac.uk/id/eprint/20479

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