40 | Chapter 3 Table 3. Cardiac imaging parameters of patients without and with life-threatening arrhythmia Echocardiography All (n=160) No VA (n=113) VA (n=47) p-value RVD, mm 41 ± 10 38 ± 7 48 ± 12 <0.001 RVFAC, % 38 ± 11 42 ± 9 29 ± 9 <0.001 RV deformation pattern I, n(%) 43 (27) 42 (37) 1 (2) <0.001 RV deformation pattern II, n(%) 56 (35) 40 (35) 16 (34) 0.87 RV deformation pattern III, n(%) 61 (38) 31 (27) 30 (64) <0.001 RVFWSL, % -19.3 ± 7.6 -21.4 ± 6.5 -14.0 ± 7.7 <0.001 • Peak systolic strain basal, % -14 ± 9 -16 ± 9 -8 ± 8 <0.001 • Peak systolic strain mid, % -20 ± 8 -22 ± 7 -14 ± 8 <0.001 • Peak systolic strain apical, % -24 ± 8 -26 ± 7 -20 ± 10 <0.001 RVMD, ms 37 ± 26 30 ± 21 53 ± 30 <0.001 RVOT, mm 35 ± 8 32 ± 6 40 ± 9 <0.001 TAPSE, mm 21 ± 4 22 ± 4 18 ± 5 <0.001 LVEF, % 57 ± 7 57 ± 6 56 ± 9 0.31 GLS, % -18.1 ± 3.4 -18.7 ± 2.8 -16.7 ± 4.2 0.003 CMR (n=129) (n=95) (n=34) RVEF, % 46 ± 13 49 ± 12 37 ± 13 <0.001 RVEDVi, ml 110 ± 41 99 ± 31 148 ± 48 <0.001 LGE, n (%) 34 (27) 14 (15) 20 (59) <0.001 Values are, n (%), mean ± standard deviation. Abbreviations: CMR = cardiac magnetic resonance, EDVi = end diastolic volume indexed, EF = ejection fraction, FAC = fractional area change, GLS = global longitudinal strain, LGE = late gadolinium enhancement, LV = left ventricle, MD = mechanical dispersion, RV = right ventricle, RVD = right ventricular diameter, RVFWSL = right ventricular free wall longitudinal strain, RVOT = right ventricular outflow tract, TAPSE = tricuspid annular plane systolic excursion. ROC analysis showed a reasonable association between deformation pattern recognition and VA (AUC 0.74, 95%CI (0.66 – 0.82)) and between RV mechanical dispersion and VA (AUC 0.78, 95%CI (0.71 – 0.86)), when used separately. We observed no difference between the associations in the Oslo and Utrecht cohort for both pattern recognition (AUC 0.77, 95%CI (0.68 – 0.86) vs. 0.72, 95%CI (0.61 – 0.83), p = 0.49), and RV mechanical dispersion (AUC 0.76, 95%CI (0.65 – 0.88) vs. 0.81, 95%CI (0.72 – 0.91), p = 0.50). All deformation analyses showed excellent intra- and inter-observer agreement. (Supplementary material) Combining the two RV deformation methods RV deformation patterns and RV mechanical dispersion were partially concordant, but also independently associated with VA (adjusted OR 2.71, 95%CI (1.47 – 5.00) per step-up and 1.26, 95%CI (1.07 – 1.49) per 10 ms increment, respectively). Patients with abnormal deformation patterns (type II or III) had increased odds for VA (OR 27.21, 95%CI (3.62 – 204.63)) and within this
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