Assessment of inflammation in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia.
OBJECTIVE
Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a myocardial disease that predominantly affects the right ventricle (RV). Its hallmark feature is fibro-fatty replacement of RV myocardium. However, patchy inflammatory infiltrates in the RV are also consistently reported using autopsy and myocardial biopsy. Although the role of inflammation in ARVC/D is unresolved, the ability to assess inflammation non-invasively may aid in the diagnostic process. We aimed to establish whether cardiac inflammation can be assessed non-invasively in ARVC/D patients.


METHODS
In eight ARVC/D patients and nine controls (haematology/oncology patients), the level of inflammatory activation was assessed by measuring plasma levels of inflammatory cytokines. Regional myocardial inflammation was assessed with (67)Ga scintigraphy.


RESULTS
ARVC/D patients had higher plasma levels than controls of the pro-inflammatory cytokines interleukin (IL)-1β (1.22 ± 0.07 vs 0.08 ± 0.01 pg/ml, p < 0.0001), IL-6 (3.16 ± 0.44 vs 0.38 ± 0.04 pg/ml, p < 0.0001) and tumour necrosis factor (TNF)-α (9.16 ± 0.90 vs 0.40 ± 0.06 pg/ml, p < 0.0001), while levels of the anti-inflammatory cytokine IL-10 were not significantly different (1.36 ± 0.15 vs 1.20 ± 0.30 pg/ml, p = 0.74). (67)Ga uptake in the RV was higher in ARVC/D patients than in controls. In ARVC/D patients, (67)Ga uptake in the RV wall was higher than in the interventricular septum or left ventricular wall.


CONCLUSIONS
Inflammation in the RV wall of ARVC/D patients can be detected non-invasively with the combined analysis of plasma levels of inflammatory cytokines and cardiac (67)Ga scintigraphy.
Campian
Maria E
ME
University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
Verberne
Hein J
HJ
Hardziyenka
Maxim
M
de Groot
Elisabeth A A
EA
van Moerkerken
Astrid F
AF
van Eck-Smit
Berthe L F
BL
Tan
Hanno L
HL
D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications*; D001692:Biological Transport; D016207:Cytokines / Q000097:blood; D005260:Female; D005710:Gallium Radioisotopes / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D011877:Radionuclide Imaging; D055815:Young Adult
D016207:Cytokines; D005710:Gallium Radioisotopes