Diagnostic and Prognostic Value of Right Ventricular Fat Quantification from Computed Tomography in Arrhythmogenic Right Ventricular Cardiomyopathy
In arrhythmogenic right ventricular cardiomyopathy (ARVC) non-invasive scar evaluation is not included among the diagnostic criteria or the predictors of ventricular arrhythmias (VA) and sudden death (SD). Computed tomography (CT) has excellent spatial resolution and allows a clear distinction betwe...
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| Veröffentlicht in: | Journal of clinical medicine 2024-06, Vol.13 (13), p.3674 |
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| creator | Faga, Valentina Ruiz Cueto, María Viladés Medel, David Moreno-Weidmann, Zoraida Dallaglio, Paolo D Diez Lopez, Carles Roura, Gerard Guerra, Jose M Leta Petracca, Rubén Gomez-Hospital, Joan Antoni Comin Colet, Josep Anguera, Ignasi Di Marco, Andrea |
| description | In arrhythmogenic right ventricular cardiomyopathy (ARVC) non-invasive scar evaluation is not included among the diagnostic criteria or the predictors of ventricular arrhythmias (VA) and sudden death (SD). Computed tomography (CT) has excellent spatial resolution and allows a clear distinction between myocardium and fat; thus, it has great potential for the evaluation of myocardial scar in ARVC.
The objective of this study is to evaluate the feasibility, and the diagnostic and prognostic value of semi-automated quantification of right ventricular (RV) fat replacement from CT images.
An observational case-control study was carried out including 23 patients with a definite (19) or borderline (4) ARVC diagnosis and 23 age- and sex-matched controls without structural heart disease. All patients underwent contrast-enhanced cardiac CT. RV images were semi-automatically reconstructed with the ADAS-3D software (ADAS3D Medical, Barcelona, Spain). A fibrofatty scar was defined as values of Hounsfield Units (HU) |
| doi_str_mv | 10.3390/jcm13133674 |
| format | Article |
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The objective of this study is to evaluate the feasibility, and the diagnostic and prognostic value of semi-automated quantification of right ventricular (RV) fat replacement from CT images.
An observational case-control study was carried out including 23 patients with a definite (19) or borderline (4) ARVC diagnosis and 23 age- and sex-matched controls without structural heart disease. All patients underwent contrast-enhanced cardiac CT. RV images were semi-automatically reconstructed with the ADAS-3D software (ADAS3D Medical, Barcelona, Spain). A fibrofatty scar was defined as values of Hounsfield Units (HU) <-10. Within the scar, a border zone (between -10 HU and -50 HU) and dense scar (<-50 HU) were distinguished.
All ARVC patients had an RV scar and all scar-related measurements were significantly higher in ARVC cases than in controls (
< 0.001). The total scar area and dense scar area showed no overlapping values between cases and controls, achieving perfect diagnostic performance (sensitivity and specificity of 100%). Among ARVC patients, 16 (70%) had experienced sustained VA or aborted SD. Among all clinical, ECG and imaging parameters, the dense scar area was the only one with a statistically significant association with VA and SD (
= 0.003).
In ARVC, RV myocardial fat quantification from CT is feasible and may have considerable diagnostic and prognostic value.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm13133674</identifier><identifier>PMID: 38999240</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Cardiomyopathy ; Contrast agents ; Genomics ; Medical imaging ; Patients ; Radiation ; Rare diseases ; Software ; Tomography</subject><ispartof>Journal of clinical medicine, 2024-06, Vol.13 (13), p.3674</ispartof><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c242t-fd43e0680f4517c5aaf0b7e2f2b537348418d7db43951e5459eff652fa369bda3</cites><orcidid>0000-0002-3734-4777 ; 0000-0003-4691-381X ; 0000-0001-8322-8112 ; 0000-0002-3638-9703 ; 0000-0001-8780-720X ; 0000-0001-5397-9177</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38999240$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Faga, Valentina</creatorcontrib><creatorcontrib>Ruiz Cueto, María</creatorcontrib><creatorcontrib>Viladés Medel, David</creatorcontrib><creatorcontrib>Moreno-Weidmann, Zoraida</creatorcontrib><creatorcontrib>Dallaglio, Paolo D</creatorcontrib><creatorcontrib>Diez Lopez, Carles</creatorcontrib><creatorcontrib>Roura, Gerard</creatorcontrib><creatorcontrib>Guerra, Jose M</creatorcontrib><creatorcontrib>Leta Petracca, Rubén</creatorcontrib><creatorcontrib>Gomez-Hospital, Joan Antoni</creatorcontrib><creatorcontrib>Comin Colet, Josep</creatorcontrib><creatorcontrib>Anguera, Ignasi</creatorcontrib><creatorcontrib>Di Marco, Andrea</creatorcontrib><title>Diagnostic and Prognostic Value of Right Ventricular Fat Quantification from Computed Tomography in Arrhythmogenic Right Ventricular Cardiomyopathy</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>In arrhythmogenic right ventricular cardiomyopathy (ARVC) non-invasive scar evaluation is not included among the diagnostic criteria or the predictors of ventricular arrhythmias (VA) and sudden death (SD). Computed tomography (CT) has excellent spatial resolution and allows a clear distinction between myocardium and fat; thus, it has great potential for the evaluation of myocardial scar in ARVC.
The objective of this study is to evaluate the feasibility, and the diagnostic and prognostic value of semi-automated quantification of right ventricular (RV) fat replacement from CT images.
An observational case-control study was carried out including 23 patients with a definite (19) or borderline (4) ARVC diagnosis and 23 age- and sex-matched controls without structural heart disease. All patients underwent contrast-enhanced cardiac CT. RV images were semi-automatically reconstructed with the ADAS-3D software (ADAS3D Medical, Barcelona, Spain). A fibrofatty scar was defined as values of Hounsfield Units (HU) <-10. Within the scar, a border zone (between -10 HU and -50 HU) and dense scar (<-50 HU) were distinguished.
All ARVC patients had an RV scar and all scar-related measurements were significantly higher in ARVC cases than in controls (
< 0.001). The total scar area and dense scar area showed no overlapping values between cases and controls, achieving perfect diagnostic performance (sensitivity and specificity of 100%). Among ARVC patients, 16 (70%) had experienced sustained VA or aborted SD. Among all clinical, ECG and imaging parameters, the dense scar area was the only one with a statistically significant association with VA and SD (
= 0.003).
In ARVC, RV myocardial fat quantification from CT is feasible and may have considerable diagnostic and prognostic value.</description><subject>Cardiomyopathy</subject><subject>Contrast agents</subject><subject>Genomics</subject><subject>Medical imaging</subject><subject>Patients</subject><subject>Radiation</subject><subject>Rare diseases</subject><subject>Software</subject><subject>Tomography</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNplkU1LHTEUhkNRqqir7kugm0K5ms-bZCm3tRWEqqjb4cxMcieXmWSaZBbzO_qHO_WjSD2b88HDw4EXoQ-UnHJuyNmuGSinnK-VeIcOGVFqRbjme6_mA3SS844spbVgVL1HB1wbY5ggh-j3Vw_bEHPxDYbQ4usUX9YH6CeLo8O3ftsV_GBDSb6Zekj4Agq-mSAU73wDxceAXYoD3sRhnIpt8V0c4jbB2M3YB3yeUjeXbjnZsIjf-jaQWh-HOY5QuvkY7Tvosz157kfo_uLb3ebH6urn98vN-dWqYYKVlWsFt2StiROSqkYCOFIryxyrJVdcaEF1q9pacCOplUIa69xaMgd8beoW-BH6_OQdU_w12VyqwefG9j0EG6dccaKMllpSs6Cf_kN3cUph-e6RolIqyhbqyxPVpJhzsq4akx8gzRUl1d-4qldxLfTHZ-dUD7b9x76Ew_8ASKWShw</recordid><startdate>20240624</startdate><enddate>20240624</enddate><creator>Faga, Valentina</creator><creator>Ruiz Cueto, María</creator><creator>Viladés Medel, David</creator><creator>Moreno-Weidmann, Zoraida</creator><creator>Dallaglio, Paolo D</creator><creator>Diez Lopez, Carles</creator><creator>Roura, Gerard</creator><creator>Guerra, Jose M</creator><creator>Leta Petracca, Rubén</creator><creator>Gomez-Hospital, Joan Antoni</creator><creator>Comin Colet, Josep</creator><creator>Anguera, Ignasi</creator><creator>Di Marco, Andrea</creator><general>MDPI AG</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3734-4777</orcidid><orcidid>https://orcid.org/0000-0003-4691-381X</orcidid><orcidid>https://orcid.org/0000-0001-8322-8112</orcidid><orcidid>https://orcid.org/0000-0002-3638-9703</orcidid><orcidid>https://orcid.org/0000-0001-8780-720X</orcidid><orcidid>https://orcid.org/0000-0001-5397-9177</orcidid></search><sort><creationdate>20240624</creationdate><title>Diagnostic and Prognostic Value of Right Ventricular Fat Quantification from Computed Tomography in Arrhythmogenic Right Ventricular Cardiomyopathy</title><author>Faga, Valentina ; 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Computed tomography (CT) has excellent spatial resolution and allows a clear distinction between myocardium and fat; thus, it has great potential for the evaluation of myocardial scar in ARVC.
The objective of this study is to evaluate the feasibility, and the diagnostic and prognostic value of semi-automated quantification of right ventricular (RV) fat replacement from CT images.
An observational case-control study was carried out including 23 patients with a definite (19) or borderline (4) ARVC diagnosis and 23 age- and sex-matched controls without structural heart disease. All patients underwent contrast-enhanced cardiac CT. RV images were semi-automatically reconstructed with the ADAS-3D software (ADAS3D Medical, Barcelona, Spain). A fibrofatty scar was defined as values of Hounsfield Units (HU) <-10. Within the scar, a border zone (between -10 HU and -50 HU) and dense scar (<-50 HU) were distinguished.
All ARVC patients had an RV scar and all scar-related measurements were significantly higher in ARVC cases than in controls (
< 0.001). The total scar area and dense scar area showed no overlapping values between cases and controls, achieving perfect diagnostic performance (sensitivity and specificity of 100%). Among ARVC patients, 16 (70%) had experienced sustained VA or aborted SD. Among all clinical, ECG and imaging parameters, the dense scar area was the only one with a statistically significant association with VA and SD (
= 0.003).
In ARVC, RV myocardial fat quantification from CT is feasible and may have considerable diagnostic and prognostic value.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>38999240</pmid><doi>10.3390/jcm13133674</doi><orcidid>https://orcid.org/0000-0002-3734-4777</orcidid><orcidid>https://orcid.org/0000-0003-4691-381X</orcidid><orcidid>https://orcid.org/0000-0001-8322-8112</orcidid><orcidid>https://orcid.org/0000-0002-3638-9703</orcidid><orcidid>https://orcid.org/0000-0001-8780-720X</orcidid><orcidid>https://orcid.org/0000-0001-5397-9177</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Cardiomyopathy Contrast agents Genomics Medical imaging Patients Radiation Rare diseases Software Tomography |
| title | Diagnostic and Prognostic Value of Right Ventricular Fat Quantification from Computed Tomography in Arrhythmogenic Right Ventricular Cardiomyopathy |
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