title: The diagnostic performance of imaging methods in ARVC using the 2010 Task Force criteria.
abstract: OBJECTIVE
  This study evaluates the agreement between echocardiographic and cardiac magnetic resonance (CMR) imaging data, and the impact a discrepancy between the two may have on the clinical diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC).
  
  
  RESULTS
  From the Nordic ARVC Registry, 102 patients with definite ARVC who had undergone both echocardiography and CMR were included (median age 42 ± 16 years, 36% female, 78% probands). Patients were divided into two groups according to CMR-positive or -negative criteria, and the echocardiographic data were compared between the two. There were 72 CMR-positive patients. They had significantly larger RV dimensions and lower fractional area change on echocardiography compared with CMR-negative patients; parasternal long-axis right ventricular outflow tract (RVOT) 37 ± 7 vs. 32 ± 5 mm, parasternal short-axis RVOT 38 ± 7 vs. 32 ± 6 mm, fractional area shortening 31 ± 9 vs. 39 ± 9% (P < 0.003 for all). Only 36 (50%) of the CMR-positive patients fulfilled ARVC criteria by echocardiography, hence the diagnostic performance was low; sensitivity 50% and specificity 70%, positive predictive value 80% and negative predictive value 37%. Individuals with regional wall abnormalities on CMR were more likely to have ventricular arrhythmias (77 vs. 57%, P = 0.047).
  
  
  CONCLUSIONS
  A significant proportion of patients with imaging-positive ARVC by CMR did not fulfil echocardiographic ARVC 2010 criteria. These findings confirm that echocardiographic evaluation of subtle structural changes in the right ventricle may be unreliable, and the diagnostic performance of CMR compared with echocardiography should be reflected in the guidelines.
authors.affiliation: Arrhythmia Clinic, Lund University, Skane University Hospital, Getingevagen, 221 85 Lund, Sweden rasmus.borgquist@med.lu.se rasmus.borgquist@skane.se.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Borgquist
authors.affiliation: Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet and University of Oslo, Oslo, Norway.
authors.forename: Kristina H
authors.initials: KH
authors.lastname: Haugaa
authors.affiliation: Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gilljam
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark Danish Arrhythmia Research Centre, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Bundgaard
authors.affiliation: Gentofte University Hospital, Copenhagen, Denmark.
authors.forename: Jim
authors.initials: J
authors.lastname: Hansen
authors.affiliation: Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Ole
authors.initials: O
authors.lastname: Eschen
authors.affiliation: Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark.
authors.forename: Henrik Kjærulf
authors.initials: HK
authors.lastname: Jensen
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark Danish Arrhythmia Research Centre, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Anders G
authors.initials: AG
authors.lastname: Holst
authors.affiliation: Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet and University of Oslo, Oslo, Norway.
authors.forename: Thor
authors.initials: T
authors.lastname: Edvardsen
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark Danish Arrhythmia Research Centre, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jesper H
authors.initials: JH
authors.lastname: Svendsen
authors.affiliation: Arrhythmia Clinic, Lund University, Skane University Hospital, Getingevagen, 221 85 Lund, Sweden.
authors.forename: Pyotr G
authors.initials: PG
authors.lastname: Platonov
mesh_terms: D000328:Adult; D026683:Advisory Committees; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D003718:Denmark / Q000453:epidemiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009664:Norway / Q000453:epidemiology; D012042:Registries; D012680:Sensitivity and Specificity; D013548:Sweden / Q000453:epidemiology
keywords: ARVC; Cardiac magnetic resonance imaging; Diagnostic performance; Echocardiography