Angiographic Assessment of Right Ventricular Morphology

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S56 Abstracts Heart, Lung and Circulation2008;17S:S1–S209

Baseline clinical data including symptoms, ECG find-ings, cardiac enzymes were assessed. Cardiac MRI wasperformed (GE Healthcare 1.5 T Signa Twinspeed systemwith eight-element cardiac phased array coil. Steady-statefree precession cine MR imaging series were acquiredto provide functional assessment of the ventricles. Tripleinversion recovery (TIR) sequences were performed todetect the presence of oedema. Delayed enhancementimaging was performed in the same imaging planesand acquired after administration of 0.2 mmol/kg ofgadolinium-DTPA using an inversion time of 200–250 ms.Findings: Fifty-eight patients were identified (mean age36.4 years, 77% male) having presented with a clinicalsyndrome consistent with acute myopericarditis. Mostpatients had infective symptoms of either respiratory orgastrointestinal tract and either chest pain or breathless-ness as part of their presenting symptoms. The majorityhad raised cardiac enzymes (95%), inflammatory mark-ers and ECG changes. MRI findings were highly variable.Eighty-seven percent had evidence of delayed enhance-ment in a patchy, midwall and subepicardial locationsnon-coronary distribution. Thirty-five percent had evi-dence of oedema on TIR imaging. Twenty-seven percenthad reduced left ventricular function though mean EF was52% (range 33–63). Follow-up scans were performed in14 patients. These showed reduction in extent of delayedenhancement and an overall improvement in ventricular

experienced observers. Assessment was done for RVdilatation, regional wall motion abnormalities (RWMAs),arrangement of trabeculae, presence of abnormal trabec-ular pattern and micro-aneurysms. Apical, antero-lateral,basal and outflow tract were looked at for RWMAs. Ade-quacy of filling with contrast and number of ectopics wererecorded.Results: Patients age ranged from 25 to 79 years; 14 werefemale and 32 male. Regional or global RV dilatation waspresent in 17 patients. In 12 patients the dilatation couldnot be explained by coronary artery disease (CAD) orother disease. RWMAs were observed in 13 patients; in8 patients RWMAs could not be explained by CAD. Tra-becular pattern was abnormal in 10 patients and 2 patientshad microaneurysms.Conclusion: Structural abnormalities may be observedin RV angiograms without evident cause; their presenceshould be interpreted with caution in suspected ARVDpatients.

doi:10.1016/j.hlc.2008.05.130

130Evaluation of Left Ventricular Strain and Dyssynchronyin Patients with Fabry Disease

Anita Boyd 1,∗, Norman Sadick 1, David Sillence 1, LizaThomas 2

systolic function compared to baseline.Conclusion: MRI provides a unique set of imaging crite-ria to aid in the assessment of myopericarditis and in thefuture may have some prognostic role in this condition.

doi:10.1016/j.hlc.2008.05.129

129Angiographic Assessment of Right Ventricular Morphol-ogy

Jamil Ahmed ∗, Warren Smith, Christopher Occleshaw,Peter Ruygrok, Margaret Hood, Nigel Lever

Green Lane Cardiovascular Service, Auckland, New Zealand

Background: Arrythmogenic right ventricular dysplasia(ARVD) is a common cause of sudden cardiac death. Char-acterised by fibro-fatty degeneration of right ventricular(RV) myocardium, definitive diagnosis requires histologi-cal confirmation at postmortem or surgery. RV structuralabnormalities are part of the diagnostic criteria set by atask force. RV angiography is commonly used to diagnosestructural abnormality. Because of the semi-lunar shapeand complex geometry of right ventricle, it is often dif-ficult to distinguish between normal and abnormal rightventricles. This study aimed to assess the angiographic RVmorphology in a control group to define a normal spec-trum and acceptable deviations from normal range.Methods: Forty-six patients were recruited from patientspresenting for diagnostic coronary angiography. In addi-tion to coronary angiography they underwent bi-plane RVangiography. Patients’ demographics data were recorded.The angiograms were analysed qualitatively by two

1 Westmead Hospital/University of Sydney, Sydney, NSW,Australia; 2 Liverpool Hospital/University of NSW, Sydney,NSW, Australia

Background: Fabry disease is associated with left ventric-ular hypertrophy (LVH) and fibrosis. This study evaluatedregional left ventricular function using Doppler tissueimaging (DTI) measures of strain and dyssynchrony inpatients with Fabry disease.Methods: Echocardiograms were performed on 24 Fabrypatients who were compared to age and gender matchednormals. Subgroup analysis was performed in Fabrypatients with LVH (n = 15) and without LVH (n = 9). UsingDTI, peak systolic strain was measured from basal andmid ventricular segments in apical four and two chamberviews. Intraventricular dyssynchrony was calculated as thestandard deviation of time from isovolumic contraction topeak systolic S’ from the eight segments.Results: Left ventricular ejection fraction did not differbetween Fabry and Normals (57 ± 8 vs. 59 ± 6, p = 0.3)and LVH did not affect ejection fraction (p = 0.2). Strainwas significantly reduced in Fabry patients in all seg-ments, except mid anterior. In Fabry patients with LVH,strain was uniformly reduced in all segments, while inthose without LVH, strain was significantly reduced onlyin basal segments. There was significant intraventriculardyssynchrony in the Fabry patients compared to normals(15 ± 7 ms vs. 12 ± 5 ms, p = 0.04).