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980
Heart 2004;90:980
IMAGES IN CARDIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
doi: 10.1136/hrt.2003.033340
Transthoracic tissue Doppler study of right ventricular regional function in a patient with an
arrhythmogenic right ventricular cardiomyopathy
A
45 year old man was admitted because
of ventricular tachycardia. He was
known to suffer from arrhythmogenic
right ventricular cardiomyopathy (ARVC).
The rhythmic instability was quickly managed with amiodarone and atenolol. During
evaluation of the patient’s cardiomyopathy,
echocardiography was performed. Left ventricular global function was normal, but
hypokinesia of the basal segment of the
lateral wall was observed. The right ventricle
was enlarged and appeared hypokinetic,
especially at the apex in apical long axis
view. The pulmonary infundibulum was
enlarged (upper panel). We looked at the
tissue Doppler characteristics of the right
ventricle, especially the free wall, to quantify
regional right ventricular function. We then
used tissue Doppler velocity (TVI) curve
analysis (lower panel) and observed the
disappearance of the base–mid apex velocity
gradient, and the presence of an isovolumic
relaxation event on the TVI curves of the
ARVC patient, contrary to what is seen in
normal individuals.
E Donal
P Raud-Raynier
[email protected]
(A) Parasternal short axis view with the enlarged pulmonary infundibulum and the pulmonary valve
regurgitation. (B) Same view looking at the left ventricle (LV) and the enlarged right ventricle (RV).
(C) Same observation in apical view. (D) Dilated inferior vena cava.
Tissue Doppler velocity (TVI) curve analysis and tissue tracking performed in one of the ARVC patients. There is no base–mid apex gradient, unlike in
the control subject with normal right ventricular function. Note the presence of a negative isovolumic relaxation velocity in the ARVC patient (Q). The
isovolumic relaxation is free of any event in the normal subject.
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Downloaded from http://heart.bmj.com/ on May 8, 2017 - Published by group.bmj.com
Transthoracic tissue Doppler study of right
ventricular regional function in a patient with an
arrhythmogenic right ventricular
cardiomyopathy
E Donal and P Raud-Raynier
Heart 2004 90: 980
doi: 10.1136/hrt.2003.033340
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