46 | Chapter 3 CONCLUSION This study is the first to externally validate the use of RV deformation pattern recognition and RV mechanical dispersion in AC. RV deformation patterns and mechanical dispersion were independently associated with life-threatening ventricular arrhythmia. Importantly, we observed an added value of combining mechanical dispersion and RV deformation patterns for optimal detection of patients with a history of VA. Future larger prospective studies should investigate the value of combining both parameters in a multimodality risk prediction approach. PERSPECTIVES Clinical competencies The use of cascade genetic screening in arrhythmogenic cardiomyopathy is presenting clinicians with an expanding group of asymptomatic genotype positive relatives with an important arrhythmic risk. Deformation imaging detects early structural and functional abnormalities indicating increased risk of ventricular arrhythmias and may help risk stratification in early disease. Translational outlook Deformation imaging in the easily available echocardiographic assessment has become part of daily clinical practice in many centers. We compared two cohorts of patients with arrhythmogenic cardiomyopathy from two different centers and externally validated two methods of deformation imaging. Both methods showed validity for detection of early structural and functional abnormalities and the combination of the methods increased clinical risk stratification of patients with arrhythmogenic cardiomyopathy. Acknowledgements: The authors would like to thank Margareth Ribe and Maria Ruud for their work as research coordinators. This work was supported by the Norwegian Research Council (project 288438). Folkert Asselbergs is supported by UCL Hospitals NIHR Biomedical Research Centre.
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