The use of 2-D speckle tracking echocardiography in differentiating healthy adolescent athletes with right ventricular outflow tract dilation from patients with arrhythmogenic cardiomyopathy
Echocardiographic assessment of adolescent athletes for arrhythmogenic cardiomyopathy (ACM) can be challenging owing to right ventricular (RV) exercise-related remodelling, particularly RV outflow tract (RVOT) dilation. The aim of this study is to evaluate the role of RV 2-D speckle tracking echocar...
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| Veröffentlicht in: | International journal of cardiology 2023-07, Vol.382, p.98-105 |
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| creator | Dorobantu, Dan M. Riding, Nathan McClean, Gavin de la Garza, María-Sanz Abuli-Lluch, Marc Sharma, Chetanya Duarte, Nuno Adamuz, Maria Carmen Watt, Victoria Hamilton, Robert M. Ryding, Diane Perry, Dave McNally, Steve Stuart, A. Graham Sitges, Marta Oxborough, David L. Wilson, Mathew Friedberg, Mark K. Williams, Craig A. Pieles, Guido E. |
| description | Echocardiographic assessment of adolescent athletes for arrhythmogenic cardiomyopathy (ACM) can be challenging owing to right ventricular (RV) exercise-related remodelling, particularly RV outflow tract (RVOT) dilation. The aim of this study is to evaluate the role of RV 2-D speckle tracking echocardiography (STE) in comparing healthy adolescent athletes with and without RVOT dilation to patients with ACM.
A total of 391 adolescent athletes, mean age 14.5 ± 1.7 years, evaluated at three sports academies between 2014 and 2019 were included, and compared to previously reported ACM patients (n = 38 definite and n = 39 borderline). Peak systolic RV free wall (RVFW-Sl), global and segmental strain (Sl), and corresponding strain rates (SRl) were calculated. The participants meeting the major modified Task Force Criteria (mTFC) for RVOT dilation were defined as mTFC+ (n = 58, 14.8%), and the rest as mTFC- (n = 333, 85.2%). Mean RVFW-Sl was −27.6 ± 3.4% overall, −28.2 ± 4.1% in the mTFC+ group and − 27.5 ± 3.3% in the mTFC- group. mTFC+ athletes had normal RV-FW-Sl when compared to definite (−29% vs −19%, p |
| doi_str_mv | 10.1016/j.ijcard.2023.04.001 |
| format | Article |
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A total of 391 adolescent athletes, mean age 14.5 ± 1.7 years, evaluated at three sports academies between 2014 and 2019 were included, and compared to previously reported ACM patients (n = 38 definite and n = 39 borderline). Peak systolic RV free wall (RVFW-Sl), global and segmental strain (Sl), and corresponding strain rates (SRl) were calculated. The participants meeting the major modified Task Force Criteria (mTFC) for RVOT dilation were defined as mTFC+ (n = 58, 14.8%), and the rest as mTFC- (n = 333, 85.2%). Mean RVFW-Sl was −27.6 ± 3.4% overall, −28.2 ± 4.1% in the mTFC+ group and − 27.5 ± 3.3% in the mTFC- group. mTFC+ athletes had normal RV-FW-Sl when compared to definite (−29% vs −19%, p < 0.001) and borderline ACM (−29% vs −21%, p < 0.001) cohorts. In addition, all mean global and regional Sl and SRl values were no worse in the mTFC+ group compared to the mTFC- (p values range < 0.0001 to 0.1, inferiority margin of 2% and 0.1 s−1 respectively).
In athletes with RVOT dilation meeting the major mTFC, STE evaluation of the RV can demostrate normal function and differentiate physiological remodelling from pathological changes found in ACM, improving screening in grey-area cases.
The use of 2D speckle tracking echocardiography in the assessment of the athlete RV. [Display omitted]
•Training induced right ventricular outflow dilation is frequent in athletes and can raise suspicion of cardiomyopathy•These athletes have normal right ventricular myocardial mechanics, in contrast with confirmed and borderline non-athlete cases.•Speckle tracking echocardiography can improve current screening criteria in athletes with right ventricular outflow dilation</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2023.04.001</identifier><identifier>PMID: 37030404</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adolescent ; Arrhythmogenic cardiomyopathy ; Arrhythmogenic Right Ventricular Dysplasia - diagnostic imaging ; Athletes ; Child ; Dilatation ; Echocardiography - methods ; Humans ; Paediatric athlete ; Preparticipation screening ; Right ventricle longitudinal strain ; Speckle tracking echocardiography ; Ventricular Dysfunction, Right ; Ventricular Function, Right - physiology ; Ventricular Remodeling - physiology</subject><ispartof>International journal of cardiology, 2023-07, Vol.382, p.98-105</ispartof><rights>2023 The Author(s)</rights><rights>Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-44831fe01f1e7e47fa8f366d4e65631309df97c0978271a0b8bfcf14aeb29fe43</citedby><cites>FETCH-LOGICAL-c408t-44831fe01f1e7e47fa8f366d4e65631309df97c0978271a0b8bfcf14aeb29fe43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0167527323005156$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37030404$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dorobantu, Dan M.</creatorcontrib><creatorcontrib>Riding, Nathan</creatorcontrib><creatorcontrib>McClean, Gavin</creatorcontrib><creatorcontrib>de la Garza, María-Sanz</creatorcontrib><creatorcontrib>Abuli-Lluch, Marc</creatorcontrib><creatorcontrib>Sharma, Chetanya</creatorcontrib><creatorcontrib>Duarte, Nuno</creatorcontrib><creatorcontrib>Adamuz, Maria Carmen</creatorcontrib><creatorcontrib>Watt, Victoria</creatorcontrib><creatorcontrib>Hamilton, Robert M.</creatorcontrib><creatorcontrib>Ryding, Diane</creatorcontrib><creatorcontrib>Perry, Dave</creatorcontrib><creatorcontrib>McNally, Steve</creatorcontrib><creatorcontrib>Stuart, A. Graham</creatorcontrib><creatorcontrib>Sitges, Marta</creatorcontrib><creatorcontrib>Oxborough, David L.</creatorcontrib><creatorcontrib>Wilson, Mathew</creatorcontrib><creatorcontrib>Friedberg, Mark K.</creatorcontrib><creatorcontrib>Williams, Craig A.</creatorcontrib><creatorcontrib>Pieles, Guido E.</creatorcontrib><title>The use of 2-D speckle tracking echocardiography in differentiating healthy adolescent athletes with right ventricular outflow tract dilation from patients with arrhythmogenic cardiomyopathy</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>Echocardiographic assessment of adolescent athletes for arrhythmogenic cardiomyopathy (ACM) can be challenging owing to right ventricular (RV) exercise-related remodelling, particularly RV outflow tract (RVOT) dilation. The aim of this study is to evaluate the role of RV 2-D speckle tracking echocardiography (STE) in comparing healthy adolescent athletes with and without RVOT dilation to patients with ACM.
A total of 391 adolescent athletes, mean age 14.5 ± 1.7 years, evaluated at three sports academies between 2014 and 2019 were included, and compared to previously reported ACM patients (n = 38 definite and n = 39 borderline). Peak systolic RV free wall (RVFW-Sl), global and segmental strain (Sl), and corresponding strain rates (SRl) were calculated. The participants meeting the major modified Task Force Criteria (mTFC) for RVOT dilation were defined as mTFC+ (n = 58, 14.8%), and the rest as mTFC- (n = 333, 85.2%). Mean RVFW-Sl was −27.6 ± 3.4% overall, −28.2 ± 4.1% in the mTFC+ group and − 27.5 ± 3.3% in the mTFC- group. mTFC+ athletes had normal RV-FW-Sl when compared to definite (−29% vs −19%, p < 0.001) and borderline ACM (−29% vs −21%, p < 0.001) cohorts. In addition, all mean global and regional Sl and SRl values were no worse in the mTFC+ group compared to the mTFC- (p values range < 0.0001 to 0.1, inferiority margin of 2% and 0.1 s−1 respectively).
In athletes with RVOT dilation meeting the major mTFC, STE evaluation of the RV can demostrate normal function and differentiate physiological remodelling from pathological changes found in ACM, improving screening in grey-area cases.
The use of 2D speckle tracking echocardiography in the assessment of the athlete RV. [Display omitted]
•Training induced right ventricular outflow dilation is frequent in athletes and can raise suspicion of cardiomyopathy•These athletes have normal right ventricular myocardial mechanics, in contrast with confirmed and borderline non-athlete cases.•Speckle tracking echocardiography can improve current screening criteria in athletes with right ventricular outflow dilation</description><subject>Adolescent</subject><subject>Arrhythmogenic cardiomyopathy</subject><subject>Arrhythmogenic Right Ventricular Dysplasia - diagnostic imaging</subject><subject>Athletes</subject><subject>Child</subject><subject>Dilatation</subject><subject>Echocardiography - methods</subject><subject>Humans</subject><subject>Paediatric athlete</subject><subject>Preparticipation screening</subject><subject>Right ventricle longitudinal strain</subject><subject>Speckle tracking echocardiography</subject><subject>Ventricular Dysfunction, Right</subject><subject>Ventricular Function, Right - physiology</subject><subject>Ventricular Remodeling - physiology</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-P1SAUxYnROM_Rb2AMSzetUHil3ZiY8W8yiZtxTXj08uANLRXoTPrl_Gzy7NOlK0ju75zD5SD0mpKaEtq-O9XupFUc6oY0rCa8JoQ-QTvaCV5RsedP0a5goto3gl2hFymdCCG877vn6IoJwggnfId-3VnASwIcDG6qjzjNoO894ByVvnfTEYO24RzjwjGq2a7YTXhwxkCEKTuVz4wF5XMZqSF4SLoMsMrWQ4aEH122OLqjzfihDKLTi1cRhyUbHx7_5ORi6ItTmLCJYcRzuRf0olUx2jXbMRxhchpvbxnXUCi7vkTPjPIJXl3Oa_Tj86e7m6_V7fcv324-3Faaky5XnHeMGiDUUBDAhVGdYW07cGj3LaOM9IPphSa96BpBFTl0B6MN5QoOTW-As2v0dvOdY_i5QMpydGVR79UEYUmyEX0nKOd7UVC-oTqGlCIYOUc3qrhKSuS5OXmSW3Py3JwkXJbmiuzNJWE5jDD8E_2tqgDvNwDKng8Ooky6fJOGwUXQWQ7B_T_hN0UHshM</recordid><startdate>20230701</startdate><enddate>20230701</enddate><creator>Dorobantu, Dan M.</creator><creator>Riding, Nathan</creator><creator>McClean, Gavin</creator><creator>de la Garza, María-Sanz</creator><creator>Abuli-Lluch, Marc</creator><creator>Sharma, Chetanya</creator><creator>Duarte, Nuno</creator><creator>Adamuz, Maria Carmen</creator><creator>Watt, Victoria</creator><creator>Hamilton, Robert M.</creator><creator>Ryding, Diane</creator><creator>Perry, Dave</creator><creator>McNally, Steve</creator><creator>Stuart, A. Graham</creator><creator>Sitges, Marta</creator><creator>Oxborough, David L.</creator><creator>Wilson, Mathew</creator><creator>Friedberg, Mark K.</creator><creator>Williams, Craig A.</creator><creator>Pieles, Guido E.</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20230701</creationdate><title>The use of 2-D speckle tracking echocardiography in differentiating healthy adolescent athletes with right ventricular outflow tract dilation from patients with arrhythmogenic cardiomyopathy</title><author>Dorobantu, Dan M. ; Riding, Nathan ; McClean, Gavin ; de la Garza, María-Sanz ; Abuli-Lluch, Marc ; Sharma, Chetanya ; Duarte, Nuno ; Adamuz, Maria Carmen ; Watt, Victoria ; Hamilton, Robert M. ; Ryding, Diane ; Perry, Dave ; McNally, Steve ; Stuart, A. 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Graham</creatorcontrib><creatorcontrib>Sitges, Marta</creatorcontrib><creatorcontrib>Oxborough, David L.</creatorcontrib><creatorcontrib>Wilson, Mathew</creatorcontrib><creatorcontrib>Friedberg, Mark K.</creatorcontrib><creatorcontrib>Williams, Craig A.</creatorcontrib><creatorcontrib>Pieles, Guido E.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dorobantu, Dan M.</au><au>Riding, Nathan</au><au>McClean, Gavin</au><au>de la Garza, María-Sanz</au><au>Abuli-Lluch, Marc</au><au>Sharma, Chetanya</au><au>Duarte, Nuno</au><au>Adamuz, Maria Carmen</au><au>Watt, Victoria</au><au>Hamilton, Robert M.</au><au>Ryding, Diane</au><au>Perry, Dave</au><au>McNally, Steve</au><au>Stuart, A. Graham</au><au>Sitges, Marta</au><au>Oxborough, David L.</au><au>Wilson, Mathew</au><au>Friedberg, Mark K.</au><au>Williams, Craig A.</au><au>Pieles, Guido E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The use of 2-D speckle tracking echocardiography in differentiating healthy adolescent athletes with right ventricular outflow tract dilation from patients with arrhythmogenic cardiomyopathy</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2023-07-01</date><risdate>2023</risdate><volume>382</volume><spage>98</spage><epage>105</epage><pages>98-105</pages><issn>0167-5273</issn><eissn>1874-1754</eissn><abstract>Echocardiographic assessment of adolescent athletes for arrhythmogenic cardiomyopathy (ACM) can be challenging owing to right ventricular (RV) exercise-related remodelling, particularly RV outflow tract (RVOT) dilation. The aim of this study is to evaluate the role of RV 2-D speckle tracking echocardiography (STE) in comparing healthy adolescent athletes with and without RVOT dilation to patients with ACM.
A total of 391 adolescent athletes, mean age 14.5 ± 1.7 years, evaluated at three sports academies between 2014 and 2019 were included, and compared to previously reported ACM patients (n = 38 definite and n = 39 borderline). Peak systolic RV free wall (RVFW-Sl), global and segmental strain (Sl), and corresponding strain rates (SRl) were calculated. The participants meeting the major modified Task Force Criteria (mTFC) for RVOT dilation were defined as mTFC+ (n = 58, 14.8%), and the rest as mTFC- (n = 333, 85.2%). Mean RVFW-Sl was −27.6 ± 3.4% overall, −28.2 ± 4.1% in the mTFC+ group and − 27.5 ± 3.3% in the mTFC- group. mTFC+ athletes had normal RV-FW-Sl when compared to definite (−29% vs −19%, p < 0.001) and borderline ACM (−29% vs −21%, p < 0.001) cohorts. In addition, all mean global and regional Sl and SRl values were no worse in the mTFC+ group compared to the mTFC- (p values range < 0.0001 to 0.1, inferiority margin of 2% and 0.1 s−1 respectively).
In athletes with RVOT dilation meeting the major mTFC, STE evaluation of the RV can demostrate normal function and differentiate physiological remodelling from pathological changes found in ACM, improving screening in grey-area cases.
The use of 2D speckle tracking echocardiography in the assessment of the athlete RV. [Display omitted]
•Training induced right ventricular outflow dilation is frequent in athletes and can raise suspicion of cardiomyopathy•These athletes have normal right ventricular myocardial mechanics, in contrast with confirmed and borderline non-athlete cases.•Speckle tracking echocardiography can improve current screening criteria in athletes with right ventricular outflow dilation</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>37030404</pmid><doi>10.1016/j.ijcard.2023.04.001</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | International journal of cardiology, 2023-07, Vol.382, p.98-105 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adolescent Arrhythmogenic cardiomyopathy Arrhythmogenic Right Ventricular Dysplasia - diagnostic imaging Athletes Child Dilatation Echocardiography - methods Humans Paediatric athlete Preparticipation screening Right ventricle longitudinal strain Speckle tracking echocardiography Ventricular Dysfunction, Right Ventricular Function, Right - physiology Ventricular Remodeling - physiology |
| title | The use of 2-D speckle tracking echocardiography in differentiating healthy adolescent athletes with right ventricular outflow tract dilation from patients with arrhythmogenic cardiomyopathy |
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