Importance of CMR within the task force criteria for the diagnosis of ARVC in children and adolescents

Yousef Etoom, Sindu Govindapillai, Robert Hamilton, Cedric Manlhiot, Shi Joon Yoo, Maryam Farhan, Samir Sarikouch, Brigitte Peters, Brian W. McCrindle, Lars Grosse-Wortmann

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

Background Cardiac magnetic resonance (CMR) is a component of the revised Task Force Criteria (rTFC) for the diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC). However, its diagnostic value in a pediatric population is unknown. Objectives This study examined the contribution of CMR to diagnosing ARVC using the rTFC in a pediatric population. Methods Clinical CMR studies of 142 pediatric patients evaluated for ARVC between 2005 and 2009 were reviewed. Patients were categorized into "definitive," "borderline," "possible," or "no" ARVC diagnostic groups based on the rTFC. The extent to which each element of the rTFC contributed to diagnosing ARVC was determined using a c-statistics model. Results A total of 23 (16%), 32 (23%), 37 (26%), and 50 (35%) patients had definite, borderline, possible, and no ARVC, respectively, applying the rTFC. The prevalence of regional wall motion abnormalities in these groups was 83%, 53%, 22%, and 16%, respectively (p < 0.001). By CMR, right ventricular end-diastolic volumes were 118 ± 31 cc/m2, 108 ± 22 cc/m2, 94 ± 14 cc/m2, and 92 ± 18 cc/m2, respectively (p < 0.001). Right ventricular fatty infiltration and fibrosis were detected in only 1 and 3 patients, respectively, all of whom had definitive ARVC. Of all rTFC major criteria, CMR had the largest c-statistic decline (c = -0.163). Eleven of the 23 patients (48%) with definite ARVC would not have been in this group if CMR had not been performed. Conclusions CMR parameters are important contributors to a diagnosis of ARVC in children, using the rTFC. Fatty infiltration and myocardial fibrosis provide limited value in children and adolescents.

Original languageEnglish (US)
Pages (from-to)987-995
Number of pages9
JournalJournal of the American College of Cardiology
Volume65
Issue number10
DOIs
StatePublished - Mar 17 2015
Externally publishedYes

Keywords

  • SD scores
  • cardiac magnetic resonance imaging
  • fibrosis
  • wall motion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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