Vives-Gilabert, Y.; Sanz-Sánchez, J.; Molina, P.; Cebrián Ferriols, AJ.; Igual, B.; Calvillo-Batllés, P.; Domingo, D.... (2019). Left ventricular myocardial dysfunction in arrhythmogenic cardiomyopathy with left ventricular involvement: A door to improving diagnosis. International Journal of Cardiology. 274:237-244. https://doi.org/10.1016/j.ijcard.2018.09.024
Por favor, use este identificador para citar o enlazar este ítem: http://hdl.handle.net/10251/157274
Título:
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Left ventricular myocardial dysfunction in arrhythmogenic cardiomyopathy with left ventricular involvement: A door to improving diagnosis
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Autor:
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Vives-Gilabert, Yolanda
Sanz-Sánchez, Jorge
Molina, Pilar
Cebrián Ferriols, Antonio José
Igual, Begoña
Calvillo-Batllés, Pilar
Domingo, Diana
Millet Roig, José
Martínez-Dolz, Luis
Castells, Francisco
Zorio, Esther
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Entidad UPV:
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Universitat Politècnica de València. Departamento de Ingeniería Electrónica - Departament d'Enginyeria Electrònica
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Fecha difusión:
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Resumen:
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[EN] Background: Diagnostic Task Force Criteria (TFC) for arrhythmogenic cardiomyopathy (AC) exhibit poor performance for left dominant forms. TFC only include right ventricular (RV) dysfunction (akinesia, dyssynchrony, ...[+]
[EN] Background: Diagnostic Task Force Criteria (TFC) for arrhythmogenic cardiomyopathy (AC) exhibit poor performance for left dominant forms. TFC only include right ventricular (RV) dysfunction (akinesia, dyssynchrony, volumes and ejection fraction). Moreover, cardiac magnetic resonance imaging (CMRI) assessment of left ventricular (LV) dyssynchrony has hitherto not been described. Thus, we aimed to comprehensively characterize LVCMRI behavior in AC patients.
Methods: Thirty-five AC patients with LV involvement and twenty-three non-affected family members (controls) were enrolled. Feature-tracking analysis was applied to cine CMRI to assess LV ejection fraction (LVEF), LV end-systolic and end-diastolic volume indexes, strain values and dyssynchrony. Regions with more frequent strain and dyssynchrony impairment were also studied.
Results: Radial dyssynchrony and LVEF were selected (sensitivities 54.3% and 48.6%, respectively at 100% specificity), with a threshold of 70 ms for radial dyssynchrony and 48.5% for LVEF. 71.4% of patients exceeded these thresholds (31.4% both, 22.9% only dyssynchrony and 17.1% only LVEF). Considering these cut-off values as a novel combined criterion, 30% of patients with 'borderline' or 'possible' AC following 2010 TFC would move to a 'definite' AC diagnosis. Strain was globally impaired whereas dyssynchronous regions were more often apical and located at the inferolateral wall.
Conclusions: Mirroring the RV evaluation, we suggest including LVEF and LV dyssynchrony to improve the diagnosis of AC. Two independent mechanisms can be claimed in AC patients with LV involvement: 1) decreased myocardial deformation with global LV affectation and 2) delayed myocardial contraction at localized regions.
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Palabras clave:
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Left ventricular arrhythmogenic cardiomyopathy
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Dyssynchrony
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Strain
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Cardiac magnetic resonance imaging
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Ventricular dysfunction
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Derechos de uso:
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Reconocimiento - No comercial - Sin obra derivada (by-nc-nd)
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Fuente:
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International Journal of Cardiology. (issn:
0167-5273
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DOI:
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10.1016/j.ijcard.2018.09.024
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Editorial:
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Elsevier
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Versión del editor:
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https://doi.org/10.1016/j.ijcard.2018.09.024
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Código del Proyecto:
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info:eu-repo/grantAgreement/ISCIII//PI18%2F01582/ES/Modulación del fenotipo de miocardiopatía arritmogénica para mejorar el diagnóstico, buscar nuevos tratamientos y comprender sus mecanismos fisiopatogénicos. Papel de grasa epicárdica/
info:eu-repo/grantAgreement/MINECO//RD12%2F0042%2F0029/
info:eu-repo/grantAgreement/MINECO//PI14%2F01477/ES/Mecanismos de enfermedad en la miocardiopatía arritmogénica, mejoras en su diagnóstico y búsqueda de dianas terapéuticas/
info:eu-repo/grantAgreement/ISCIII//PT17%2F0015%2F0043/
info:eu-repo/grantAgreement/MINECO//DPI2015-70821-R/ES/CARACTERIZACION DE LA MIOCARDIOPATIA ARRITMOGENICA A PARTIR DE TECNICAS AVANZADAS DE SEÑALES E IMAGENES PARA LA DEFINICION DE NUEVOS MARCADORES DIAGNOSTICOS/
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Agradecimientos:
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This work was supported by grants from the "Ministerio de Economia y Competitividad" [DPI2015-70821-R], "Instituto de Salud Carlos III" and FEDER "Union Europea, Una forma de hacer Europa" [RD12/0042/0029, PI14/01477, ...[+]
This work was supported by grants from the "Ministerio de Economia y Competitividad" [DPI2015-70821-R], "Instituto de Salud Carlos III" and FEDER "Union Europea, Una forma de hacer Europa" [RD12/0042/0029, PI14/01477, PI18/01582 and La Fe Biobank PT17/0015/0043].
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Tipo:
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Artículo
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