Layer-Specific Global Longitudinal Strain Predicts Arrhythmic Risk in Arrhythmogenic Cardiomyopathy
Background: Arrhythmogenic cardiomyopathy (AC) is a life-threatening disease which predispose to malignant arrhythmias and sudden cardiac death (SCD) in the early stages of the disease. Risk stratification relies on the electrical, genetic, and imaging data. Our study aimed to investigate how myocar...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:a5ce506d3a064dde9a068433593658822021-11-15T06:03:13ZLayer-Specific Global Longitudinal Strain Predicts Arrhythmic Risk in Arrhythmogenic Cardiomyopathy2297-055X10.3389/fcvm.2021.748003https://doaj.org/article/a5ce506d3a064dde9a068433593658822021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.748003/fullhttps://doaj.org/toc/2297-055XBackground: Arrhythmogenic cardiomyopathy (AC) is a life-threatening disease which predispose to malignant arrhythmias and sudden cardiac death (SCD) in the early stages of the disease. Risk stratification relies on the electrical, genetic, and imaging data. Our study aimed to investigate how myocardial deformation parameters may identify the subjects at risk of known predictors of major ventricular arrhythmias.Methods: A cohort of 45 subjects with definite or borderline diagnosis of AC was characterized using the advanced transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) and divided into the groups according to the potential arrhythmic risk markers, such as non-sustained ventricular tachycardia (NSVT), late gadolinium enhancement (LGE), and genetic status. Layer-specific global longitudinal strain (GLS) by TTE 2D speckle tracking was compared in patients with and without these arrhythmic risk markers.Results: In this study, 23 (51.1%) patients were men with mean age of 43 ± 16 years. Next-generation sequencing identified a potential pathogenic mutation in 39 (86.7%) patients. Thirty-nine patients presented LGE (73.3%), mostly located at the subepicardial-to-mesocardial layers. A layer-specific-GLS analysis showed worse GLS values at the epicardial and mesocardial layers in the subjects with NSVT and LGE. The epicardial GLS values of −15.4 and −16.1% were the best cut-off values for identifying the individuals with NSVT and LGE, respectively, regardless of left ventricular ejection fraction (LVEF).Conclusions: The layer-specific GLS assessment identified the subjects with high-risk arrhythmic features in AC, such as NSVT and LGE. An epicardial GLS may emerge as a potential instrument for detecting the subjects at risk of SCD in AC.Diego Segura-RodríguezDiego Segura-RodríguezFrancisco José Bermúdez-JiménezFrancisco José Bermúdez-JiménezFrancisco José Bermúdez-JiménezLorena González-CamachoEduardo Moreno EscobarEduardo Moreno EscobarRocío García-OrtaRocío García-OrtaJuan Emilio Alcalá-LópezJuan Emilio Alcalá-LópezAlicia Bautista PavésAlicia Bautista PavésJosé Manuel Oyonarte-RamírezJosé Manuel Oyonarte-RamírezSilvia López-FernándezSilvia López-FernándezMiguel ÁlvarezMiguel ÁlvarezLuis TercedorLuis TercedorJuan Jiménez-JáimezJuan Jiménez-JáimezFrontiers Media S.A.articlesudden cardiac death (SCD)late gadolinium enhancednon-sustained ventricular tachycardiaarrhythmogenic cardiomyopathy (ACM)global longitudinal strainDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
sudden cardiac death (SCD) late gadolinium enhanced non-sustained ventricular tachycardia arrhythmogenic cardiomyopathy (ACM) global longitudinal strain Diseases of the circulatory (Cardiovascular) system RC666-701 |
| spellingShingle |
sudden cardiac death (SCD) late gadolinium enhanced non-sustained ventricular tachycardia arrhythmogenic cardiomyopathy (ACM) global longitudinal strain Diseases of the circulatory (Cardiovascular) system RC666-701 Diego Segura-Rodríguez Diego Segura-Rodríguez Francisco José Bermúdez-Jiménez Francisco José Bermúdez-Jiménez Francisco José Bermúdez-Jiménez Lorena González-Camacho Eduardo Moreno Escobar Eduardo Moreno Escobar Rocío García-Orta Rocío García-Orta Juan Emilio Alcalá-López Juan Emilio Alcalá-López Alicia Bautista Pavés Alicia Bautista Pavés José Manuel Oyonarte-Ramírez José Manuel Oyonarte-Ramírez Silvia López-Fernández Silvia López-Fernández Miguel Álvarez Miguel Álvarez Luis Tercedor Luis Tercedor Juan Jiménez-Jáimez Juan Jiménez-Jáimez Layer-Specific Global Longitudinal Strain Predicts Arrhythmic Risk in Arrhythmogenic Cardiomyopathy |
| description |
Background: Arrhythmogenic cardiomyopathy (AC) is a life-threatening disease which predispose to malignant arrhythmias and sudden cardiac death (SCD) in the early stages of the disease. Risk stratification relies on the electrical, genetic, and imaging data. Our study aimed to investigate how myocardial deformation parameters may identify the subjects at risk of known predictors of major ventricular arrhythmias.Methods: A cohort of 45 subjects with definite or borderline diagnosis of AC was characterized using the advanced transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) and divided into the groups according to the potential arrhythmic risk markers, such as non-sustained ventricular tachycardia (NSVT), late gadolinium enhancement (LGE), and genetic status. Layer-specific global longitudinal strain (GLS) by TTE 2D speckle tracking was compared in patients with and without these arrhythmic risk markers.Results: In this study, 23 (51.1%) patients were men with mean age of 43 ± 16 years. Next-generation sequencing identified a potential pathogenic mutation in 39 (86.7%) patients. Thirty-nine patients presented LGE (73.3%), mostly located at the subepicardial-to-mesocardial layers. A layer-specific-GLS analysis showed worse GLS values at the epicardial and mesocardial layers in the subjects with NSVT and LGE. The epicardial GLS values of −15.4 and −16.1% were the best cut-off values for identifying the individuals with NSVT and LGE, respectively, regardless of left ventricular ejection fraction (LVEF).Conclusions: The layer-specific GLS assessment identified the subjects with high-risk arrhythmic features in AC, such as NSVT and LGE. An epicardial GLS may emerge as a potential instrument for detecting the subjects at risk of SCD in AC. |
| format |
article |
| author |
Diego Segura-Rodríguez Diego Segura-Rodríguez Francisco José Bermúdez-Jiménez Francisco José Bermúdez-Jiménez Francisco José Bermúdez-Jiménez Lorena González-Camacho Eduardo Moreno Escobar Eduardo Moreno Escobar Rocío García-Orta Rocío García-Orta Juan Emilio Alcalá-López Juan Emilio Alcalá-López Alicia Bautista Pavés Alicia Bautista Pavés José Manuel Oyonarte-Ramírez José Manuel Oyonarte-Ramírez Silvia López-Fernández Silvia López-Fernández Miguel Álvarez Miguel Álvarez Luis Tercedor Luis Tercedor Juan Jiménez-Jáimez Juan Jiménez-Jáimez |
| author_facet |
Diego Segura-Rodríguez Diego Segura-Rodríguez Francisco José Bermúdez-Jiménez Francisco José Bermúdez-Jiménez Francisco José Bermúdez-Jiménez Lorena González-Camacho Eduardo Moreno Escobar Eduardo Moreno Escobar Rocío García-Orta Rocío García-Orta Juan Emilio Alcalá-López Juan Emilio Alcalá-López Alicia Bautista Pavés Alicia Bautista Pavés José Manuel Oyonarte-Ramírez José Manuel Oyonarte-Ramírez Silvia López-Fernández Silvia López-Fernández Miguel Álvarez Miguel Álvarez Luis Tercedor Luis Tercedor Juan Jiménez-Jáimez Juan Jiménez-Jáimez |
| author_sort |
Diego Segura-Rodríguez |
| title |
Layer-Specific Global Longitudinal Strain Predicts Arrhythmic Risk in Arrhythmogenic Cardiomyopathy |
| title_short |
Layer-Specific Global Longitudinal Strain Predicts Arrhythmic Risk in Arrhythmogenic Cardiomyopathy |
| title_full |
Layer-Specific Global Longitudinal Strain Predicts Arrhythmic Risk in Arrhythmogenic Cardiomyopathy |
| title_fullStr |
Layer-Specific Global Longitudinal Strain Predicts Arrhythmic Risk in Arrhythmogenic Cardiomyopathy |
| title_full_unstemmed |
Layer-Specific Global Longitudinal Strain Predicts Arrhythmic Risk in Arrhythmogenic Cardiomyopathy |
| title_sort |
layer-specific global longitudinal strain predicts arrhythmic risk in arrhythmogenic cardiomyopathy |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/a5ce506d3a064dde9a06843359365882 |
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