Aritmojenik Sağ Ventriküler Kardiyomiyopatili Hastalarda Ventriküler Taşikardi Ablasyonu Öncesi ve Sonrası Sağ Ventrikül Fonksiyonlarının Üç Boyutlu Ekokardiyografi ile Değerlendirilmesi

Abstract

Gültekin A. E., Evaluation of Right Ventricular Functions Before and After Ventricular Tachycardia Ablation in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy with Three Dimensional Echocardiography, Hacettepe University Faculty of Medicine, Cardiology Thesis. Ankara, 2023. Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a well-characterized inherited disease. The average age is 30 and it results in sudden cardiac death, especially in adolescents. However, early diagnosis and treatment is very important because it causes ventricular tachycardia with arrhythmia. ARVC is a disease characterized by structural and functional disorders secondary to the infiltration of fat and fibrous tissue in the right ventricular myocardium, especially in the right ventricle. In ARVC, fibrous-adipose tissue replacement is most often right ventricular anterolateral or in the free wall of the septum, left ventricular involvement is rare. Akinetic or dyskinetic wall movements are observed in the functionally involved area. In our study, three-dimensional echo findings of 13 (7 Male, 6 Female; mean age 38.2 SD:±13) patients with a definite diagnosis of ARVC were evaluated retrospectively. When we look at the mean of EDV and ESV in three-dimensional echocardiographic examinations before catheter ablation, they were measured as 175,73±38,26 and 124,83±39,31, respectively. The mean RVEF value was 29.77±10,95, and the mean SV was 50.90±20.16. The mean of RVD1 and RVD2 were 50.10±4.35 cm and 44.66±5,36 cm, respectively. The mean of TAPSE was 11.80±5,54, while the mean of FAC was 27,86±10,49. The mean values of RVLS1 and RVLS2 were measured as 9.18±5,11 and 13.80±5,76, respectively. The median value was determined for the RVD3 measurement, since it is a numerical variable that does not provide the assumption of normality. The median RVD3 value before the procedure was 90,50 (85,10–100,50). In the first month after ablation of ventricular tachycardia with catheter, all patients were evaluated by control three-dimensional echocardiographic evaluation and all parameters were re-evaluated. EDV value resulted as 166.86 ±40.41 after the procedure, p value was found to be significant as <0.001. The ESV value was found to be 114.02 ±41.75 and the p value was found to be significant as <0.001. The mean RVEF was 32.80±12.08 and the p value was 0.008, which was considered a significant result. The mean LV value was found to be 52.80±20.06, p value 0.208. RVD1 and RVD2 p values of 48.90±4.01 and 43.46±5.56, respectively, were found to be significant as 0.038 and 0.014, respectively. TAPSE and FAC were 13.20±6.13 and 30.64±11.92, respectively, and their p values were 0.002 and 0.010, respectively. RVS1 and RVLS 2 values were 10.33±5.89 and 15.63±7.25, p values 0.006 and 0.008 were significant. Finally, the median value of RVD3, which is a non-parametric variable, was found to be 85.60 (80.10 – 95.30) in the post-procedure measurement, and a p value of 0.016 in favor of a significant change. When the literature is examined, no research has been found that examines the three-dimensional data of patients diagnosed with ARVC. Our work; Although the number of patients is small, it is thought that it will contribute to the literature in this context by supporting other studies.