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(Circulation. 1996;94:437-444.)
© 1996 American Heart Association, Inc.

Articles

Usefulness of Electron-Beam Computed Tomography in Arrhythmogenic Right Ventricular Dysplasia

Relationship to Electrophysiological Abnormalities and Left Ventricular Involvement

Hiroshi Tada, MD; Wataru Shimizu, MD; Tohru Ohe, MD; Seiki Hamada, MD; Takashi Kurita, MD; Naohiko Aihara, MD; Shir Kamakura, MD; Makoto Takamiya, MD; Katsuro Shimomura, MD

the Division of Cardiology, Department of Internal Medicine (H.T., W.S., T.K., N.A., S.K., K.S.), and the Department of Radiology (S.H., M.T.), National Cardiovascular Center, Osaka, Japan, and the Department of Cardiovascular Medicine (T.O.), Okayama (Japan) University Medical School.

Correspondence to Wataru Shimizu, MD, The Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, Japan 565.

Background Electron-beam computed tomography (CT) may be useful for detecting myocardial fat infiltration and diagnosing arrhythmogenic right ventricular dysplasia (ARVD). There are several characteristic electron-beam CT findings of ARVD. However, the incidence, their relation to electrophysiological abnormalities, and the usefulness of electron-beam CT for evaluating left ventricular involvement are unknown. This study aimed to clarify these issues.

Methods and Results Electron-beam CT was performed in 14 patients with ARVD (ARVD group), 16 age- and sex-matched patients with right ventricular enlargement and/or dysfunction without ARVD (RV enlargement group), and 13 control subjects (control group). The incidences of abnormal electron-beam CT findings in the three groups were examined. Furthermore, we examined the endocardial fat–infiltrated areas detected by electron-beam CT (CT-A) and electrophysiologically abnormal areas detected in the mapping study (EPS-A) and compared the relationship between them in the ARVD group. (1) The frequencies of abundant epicardial adipose tissue, low-attenuation trabeculations, scalloping of the right ventricular free wall, and intramyocardial fat deposits were 86%, 71%, 79%, and 50%, respectively, in the ARVD group, whereas these findings were not observed in the RV enlargement and control groups. (2) Three ARVD patients (21%) had adipose tissue involvement of the left ventricle. (3) The relationship between CT-A and EPS-A was as follows: CT-A>EPS-A, 71%; CT-A=EPS-A, 14%; and EPS-A only, 14%.

Conclusions Characteristic electron-beam CT findings are frequently observed only in patients with ARVD. Electron-beam CT is useful for evaluating for left ventricular involvement and can estimate EPS-A.

Key Words: ventricles • dysplasia • tomography • electrophysiology

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