title: Right Ventricular Strain and Dyssynchrony Assessment in Arrhythmogenic Right Ventricular Cardiomyopathy: Cardiac Magnetic Resonance Feature-Tracking Study.
abstract: BACKGROUND
  Analysis of right ventricular (RV) regional dysfunction by cardiac magnetic resonance (CMR) imaging in arrhythmogenic RV cardiomyopathy (ARVC) may be inadequate because of the complex contraction pattern of the RV. Aim of this study was to determine the use of RV strain and dyssynchrony assessment in ARVC using feature-tracking CMR analysis.
  
  
  RESULTS
  Thirty-two consecutive patients with ARVC referred to CMR imaging were included. Thirty-two patients with idiopathic RV outflow tract arrhythmias and 32 control subjects, matched for age and sex to the ARVC group, were included for comparison purpose. CMR imaging was performed to assess biventricular function; feature-tracking analysis was applied to the cine CMR images to assess regional and global longitudinal, circumferential, and radial RV strains and RV dyssynchrony (defined as the SD of the time-to-peak strain of the RV segments). RV global longitudinal strain (-17±5% versus -26±6% versus -29±6%; P<0.001), global circumferential strain (-9±4% versus -12±4% versus -13±5%; P=0.001), and global radial strain (18 [12-26]% versus 22 [15-32]% versus 27 [20-39]%; P=0.015) were significantly lower and SD of the time-to-peak RV strain in all 3 directions were significantly higher among patients with ARVC compared with patients with RV outflow tract arrhythmias and controls. RV global longitudinal strain >-23.2%, SD of the time-to-peak RV longitudinal strain >113.1 ms, and SD of the time-to-peak RV circumferential strain >177.1 ms allowed correct identification of 88%, 75%, and 63% of ARVC patients with no or only minor CMR criteria for ARVC diagnosis.
  
  
  CONCLUSIONS
  Strain analysis by feature-tracking CMR helps to objectively quantify global and regional RV dysfunction and RV dyssynchrony in patients with ARVC and provides incremental value over conventional cine CMR imaging.
authors.affiliation: From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Prati
authors.affiliation: From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Vitrella
authors.affiliation: From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Allocca
authors.affiliation: From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Muser
authors.affiliation: From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy.
authors.forename: Sonja Cukon
authors.initials: SC
authors.lastname: Buttignoni
authors.affiliation: From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Piccoli
authors.affiliation: From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Morocutti
authors.affiliation: From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Delise
authors.affiliation: From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pinamonti
authors.affiliation: From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Proclemer
authors.affiliation: From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Sinagra
authors.affiliation: From the Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy (G.P., D.M., G.M., A.P., G.N.); Cardiovascular Department, University Hospital "Ospedali Riuniti," Trieste, Italy (G.P., G.V., B.P., G.S.); Postgraduate School of Cardiovascular Sciences, University of Trieste, Trieste, Italy (G.P., D.M.); and Divisions of Cardiology (G.A., S.C.B., P.D.) and Radiology (G.P.), "Santa Maria dei Battuti" Hospital, Conegliano, Italy. gnucifora@outlook.com.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Nucifora
mesh_terms: D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018497:Ventricular Dysfunction, Right / Q000209:etiology / Q000503:physiopathology*
keywords: arrhythmogenic right ventricular cardiomyopathy; magnetic resonance imaging; myocardium; strain