title: Evaluation of right and left ventricular function using speckle tracking echocardiography in patients with arrhythmogenic right ventricular cardiomyopathy and their first degree relatives.
abstract: OBJECTIVE
  The identification of right ventricular abnormalities in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) in early stages is still difficult. The aim of this study was to investigate if longitudinal strain based on speckle tracking can detect subtle right (RV) or left ventricular (LV) dysfunction as an early sign of ARVC.
  
  
  RESULTS
  Seventeen male patients, fulfilling Task force criteria for ARVC, 49 (32-70) years old, nineteen male first degree relatives 29 (19-73) y.o. and twenty-two healthy male volunteers 36 (24-66) y.o participated in the study. Twelve-lead and signal-averaged electrocardiograms were recorded. All subjects underwent echocardiography. LV and RV diameters, peak systolic velocity from tissue Doppler and longitudinal strain based on speckle tracking were measured from the basal and mid segments in both ventricles. RV longitudinal strain measurement was successful in first degree relatives and controls (95 resp. 86%) but less feasible in patients (59%). Results were not systematically different between first degree relatives and controls. Using discriminant analysis, we then developed an index based on echocardiographic parameters. All normal controls had an index<l while patients with abnormal ventricles had an index between 1-4. Some of the first degree relatives deviated from the normal pattern.
  
  
  CONCLUSIONS
  Longitudinal strain of LV and RV segments was significantly lower in patients than in relatives and controls. An index was developed incorporating dimensional and functional echocardiographic parameters. In combination with genetic testing this index might help to detect early phenotype expression in mutation carriers.
authors.affiliation: Division of Clinical Physiology, Department of Medical and Health Sciences, Faculty of Health Sciences, Department of Clinical Physiology, County Council of Östergötland, Linköping University, Linköping, Sweden. meriam.astrom.aneq@lio.se
authors.forename: Meriam Åström
authors.initials: MÅ
authors.lastname: Aneq
authors.forename: Jan
authors.initials: J
authors.lastname: Engvall
authors.forename: Lars
authors.initials: L
authors.lastname: Brudin
authors.forename: Eva
authors.initials: E
authors.lastname: Nylander
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000000981:diagnostic imaging* / Q000235:genetics / Q000503:physiopathology; D015150:Echocardiography, Doppler / Q000379:methods*; D004562:Electrocardiography; D005190:Family; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016277:Ventricular Function, Left / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult