Right Ventricular Functional Abnormalities in ARVC | 41 subgroup odds for VA increased by 30% for each 10 ms increase in RV mechanical dispersion (OR 1.30, 95%CI (1.11 – 1.53) per 10 ms increase). (Central illustration) When applying the RV mechanical dispersion in the group with normal or type II deformation patterns, the odds of VA increased by approximately 45% for each 10 ms increase in dispersion (OR 1.46, 95%CI (1.08 – 1.96)). Classification significantly improved when adding RV mechanical dispersion to pattern recognition (NRI 0.42, p = 0.02 and IDI 0.06, p = 0.01). The association increased from AUC 0.74, 95%CI (0.66 – 0.82) to 0.80, 95%CI (0.73 – 0.87), p = 0.001. (Figure 3) This association was similar to the association between CMR markers and arrhythmia. (Table 4) Figure 3. Comparison of models Panel A: An improved association with life-threatening ventricular arrhythmia was found when combining RV deformation patterns and RV mechanical dispersion (RVMD), compared to taking only RV deformation patterns into account. This is expressed by an increase in area under the curve (AUC), when comparing ROC statistics. Panel B: Display of the ROC curves of the individual and combined RV deformation methods. Table 4. Association to arrhythmia of CMR vs. the combined RV deformation imaging approach AUC (95% CI) CMR marker vs. RV deformation imaging p-value RVEF (n=99) 0.73 (0.61 – 0.85) 0.74 (0.63 – 0.84) 0.95 RVEDVi (n=92) 0.81 (0.69 – 0.93) 0.77 (0.66 – 0.87) 0.53 LGE (n=125) 0.73 (0.63 – 0.82) 0.76 (0.67 – 0.84) 0.58 Abbreviations: AUC = area under the receiver operator characteristic, CI = confidence interval, CMR = cardiac magnetic resonance, EDVi = end diastolic volume indexed, EF = ejection fraction, LGE = late gadolinium enhancement, RV = right ventricular. 3
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