• J Chin Med Assoc · May 2024

    Right ventricular scalloping index as CMR-derived marker for diagnosis of arrhythmogenic right ventricular cardiomyopathy.

    • Ko-Ying Huang, Fa-Po Chung, Chao-Yu Guo, Jui-Han Chiu, Ling Kuo, Ying-Chi Lee, Ching-Yao Weng, Ying-Yueh Chang, Yenn-Jiang Lin, and Chun-Ku Chen.
    • Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
    • J Chin Med Assoc. 2024 May 1; 87 (5): 531537531-537.

    BackgroundThe cardiac magnetic resonance (CMR) evaluation of right ventricular (RV) morphologic abnormalities in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is subjective. Here, we aimed to use a quantitative index, the right ventricular scalloping index (RVSI), to standardize the measurement of RV free wall scalloping and aid in the imaging diagnosis.MethodsWe retrospectively included 15 patients with definite ARVC and 45 age- and sex-matched patients with idiopathic right ventricular outflow tract ventricular arrhythmia (RVOT-VA) as controls. The RVSI was measured from cine images on four-chamber view to evaluate its ability to distinguish between ARVC and RVOT-VA patients. Other cardiac functional parameters including strain analysis were also performed.ResultsThe RVSI was significantly higher in the ARVC than RVOT-VA group (1.56 ± 0.23 vs 1.30 ± 0.08, p < 0.001). The diagnostic performance of the RVSI was superior to the RV global longitudinal, circumferential, and radial strains, RV ejection fraction, and RV end-diastolic volume index. The RVSI demonstrated high intraobserver and interobserver reliability (intraclass correlation coefficient, 0.94 and 0.96, respectively). RVSI was a strong discriminator between ARVC and RVOT-VA patients (area under curve [AUC], 0.91; 95% CI, 0.82-0.99). A cutoff value of RVSI ≥1.49 provided an accuracy of 90.0%, specificity of 97.8%, sensitivity of 66.7%, positive predictive value (PPV) of 90.9%, and a negative predictive value (NPV) of 89.8%. In a multivariable analysis, a family history of ARVC or sudden cardiac death (odds ratio, 38.71; 95% CI, 1.48-1011.05; p = 0.028) and an RVSI ≥1.49 (odds ratio, 64.72; 95% CI, 4.58-914.63; p = 0.002) remained predictive of definite ARVC.ConclusionRVSI is a quantitative method with good performance for the diagnosis of definite ARVC.Copyright © 2024, the Chinese Medical Association.

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