title: Altered two-dimensional strain measures of the right ventricle in patients with Brugada syndrome and arrhythmogenic right ventricular dysplasia/cardiomyopathy.
abstract: OBJECTIVE
  Brugada syndrome (BrS) is an inherited channelopathy that can be characterized by mild right ventricular (RV) abnormalities that are not detectable with conventional echocardiography. The aim of this study was to evaluate the presence of RV abnormalities in BrS patients when compared with controls and a group of patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) using two-dimensional (2D) strain analysis.
  
  
  RESULTS
  We enrolled 25 BrS, 15 ARVD/C patients, and 25 controls. Right and left ventricular dimension and systo-diastolic function were evaluated by conventional echocardiography. Longitudinal systolic strain (sS) peak, systolic and early diastolic strain rate of lateral RV segments were evaluated by 2D speckle tracking analysis. Left ventricle global and segmental strain measures were also evaluated. A reduced basal or mid-RV lateral sS were the parameters mostly associated with both BrS and ARVD/C. In BrS patients the minimum sS observed in these segments was significantly lower than that of controls (-28.9±3.2% vs. -32.3±3.2%, P: 0.002) but significantly greater than that evaluated in ARVD/C patients (-24.6±6.7%, P<0.001 both vs. BrS and controls). No differences were found between the BrS and the control group when left ventricular strain measures were analysed.
  
  
  CONCLUSIONS
  By 2D strain technique it is possible to observe mild abnormalities in RV systolic and diastolic function of BrS patients that are less pronounced than those observed in ARVD/C patients. These results help to better define the phenotypic characteristics of BrS patients and represent the basis for future studies aimed at testing their clinical usefulness in BrS patients.
authors.affiliation: Cardiology Unit, Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy. massimo.iacoviello@cardio.uniba.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Iacoviello
authors.forename: Cinzia
authors.initials: C
authors.lastname: Forleo
authors.forename: Agata
authors.initials: A
authors.lastname: Puzzovivo
authors.forename: Ilaria
authors.initials: I
authors.lastname: Nalin
authors.forename: Pietro
authors.initials: P
authors.lastname: Guida
authors.forename: Matteo
authors.initials: M
authors.lastname: Anaclerio
authors.forename: Vito
authors.initials: V
authors.lastname: Marangelli
authors.forename: Sandro
authors.initials: S
authors.lastname: Sorrentino
authors.forename: Francesco
authors.initials: F
authors.lastname: Monitillo
authors.forename: Marco Matteo
authors.initials: MM
authors.lastname: Ciccone
authors.forename: Stefano
authors.initials: S
authors.lastname: Favale
mesh_terms: D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D053840:Brugada Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000503:physiopathology