Usefulness of electron-beam computed tomography in arrhythmogenic right ventricular dysplasia. Relationship to electrophysiological abnormalities and left ventricular involvement.
BACKGROUND
Electron-beam computed tomography (CT) may be useful for detecting myocardial fat infiltration and diagnosing arrhythmogenic right ventricular dysplasia (ARVD). There are several characteristic electron-beam CT findings of ARVD. However, the incidence, their relation to electrophysiological abnormalities, and the usefulness of electron-beam CT for evaluating left ventricular involvement are unknown. This study aimed to clarify these issues.


RESULTS
Electron-beam CT was performed in 14 patients with ARVD (ARVD group), 16 age- and sex-matched patients with right ventricular enlargement and/or dysfunction without ARVD (RV enlargement group), and 13 control subjects (control group). The incidences of abnormal electron-beam CT findings in the three groups were examined. Furthermore, we examined the endocardial fat-infiltrated areas detected by electron-beam CT (CT-A) and electrophysiologically abnormal areas detected in the mapping electrophysiology study (EPS-A) and compared the relationship between them in the ARVD group. (1) The frequencies of abundant epicardial adipose tissue, low-attenuation trabeculations, scalloping of the right ventricular free wall, and intramyocardial fat deposits were 86%, 71%, 79%, and 50%, respectively, in the ARVD group, whereas these findings were not observed in the RV enlargement and control groups. (2) Three ARVD patients (21%) had adipose tissue involvement of the left ventricle. (3) The relationship between CT-A and EPS-A was as follows: CT-A > EPS-A, 71%; CT-A = EPS-A, 14%; and EPS-A only, 14%.


CONCLUSIONS
Characteristic electron-beam CT findings are frequently observed only in patients with ARVD. Electron-beam CT is useful for evaluating for left ventricular involvement and can estimate EPS-A.
Tada
H
H
Department of Internal Medicine, National Cardiovascular Center, Osaka, Japan.
Shimizu
W
W
Ohe
T
T
Hamada
S
S
Kurita
T
T
Aihara
N
N
Kamakura
S
S
Takamiya
M
M
Shimomura
K
K
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D004594:Electrophysiology; D004699:Endocardium / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right