The following is a summary of “Monitoring of Arrhythmogenic RV Cardiomyopathy Across Age SpectrumI,” published in the August 2023 issue of Cardiology by Kirkels et al.
Researchers conducted a retrospective study to determine the optimal follow-up interval for patients of all ages with arrhythmogenic right ventricular cardiomyopathy (ARVC) based on the progression of LV global longitudinal strain and RV deformation abnormalities over time.
They categorized early-stage ARVC patients and genotype-positive relatives, initially without evident structural issues or ventricular arrhythmia (VA), into three age brackets: <30, 30-50, and ≥50 years old. By analyzing biventricular deformation patterns over time, disease advancement was tracked. They developed Digital Twins through imaging-based computational modeling to correlate deformity irregularities with underlying myocardial conditions. The disease progression in the three age groups was evaluated via a linear mixed model regression, employing echocardiographic deformation parameters, an exchangeable covariance structure, and individual-level random effects.
The results showed 313 echocardiographic assessments from 82 participants (57% female, mean age 39 ± 17 years, 10% probands) over 6.7 ± 3.3 years. Left ventricular global longitudinal strain exhibited mild decline across all age segments (0.1%-point per year; 95% CI, 0.05-0.15). Regarding disease progression, deterioration was more notable in the RV lateral wall across all age groups, evident in longitudinal strain (0.6%-point per year; 95% CI, 0.46-0.70) and distinct variations in myocardial properties within the Digital Twin. Six patients experienced VA during the follow-up period.
They concluded disease progression in ARVC is similar in all age groups, even in patients >50 years old.
Source: acc.org/Latest-in-Cardiology/Journal-Scans/2023/08/22/15/49/monitoring-of-myocardial-involvement