Imaging of programmed cell death in arrhythmogenic right ventricle cardiomyopathy-dysplasiaReport as inadecuate

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European Journal of Nuclear Medicine and Molecular Imaging

, Volume 38, Issue 8, pp 1500–1506

First Online: 07 May 2011Received: 25 October 2010Accepted: 06 April 2011


BackgroundArrhythmogenic right ventricular cardiomyopathy-dysplasia ARVC-D is a myocardial disease that predominantly affects the right ventricle RV. Its hallmark feature is fibrofatty replacement of the RV myocardium. Apoptosis in ARVC-D has been proposed as an important process that mediates the slow, ongoing loss of heart muscle cells which is followed by ventricular dysfunction. We aimed to establish whether cardiac apoptosis can be assessed noninvasively in patients with ARVC-D.

MethodsSix patients fulfilling the ARVC-D criteria were studied. Regional myocardial apoptosis was assessed with Tc-annexin V scintigraphy.

ResultsOverall, the RV wall showed a higher Tc-annexin V signal than the left ventricular wall p = 0.049 and the interventricular septum p = 0.026. However, significantly increased uptake of Tc-annexin V in the RV was present in only three of the six ARVC-D patients p = 0.001, compared to Tc-annexin V uptake in the RV wall of the other three patients.

ConclusionOur results are suggestive of a chamber-specific apoptotic process. Although the role of apoptosis in ARVC-D is unsolved, the ability to assess apoptosis noninvasively may aid in the diagnostic course. In addition, the ability to detect apoptosis in vivo with Tc-annexin V scintigraphy might allow individual monitoring of disease progression and response to diverse treatments aimed at counteracting ARVC-D progression.

KeywordsArrhythmogenic right ventricle cardiomyopathy-dysplasia Scintigraphy Apoptosis Tc-annexin V scintigraphy AbbreviationsTctechnetium 99m

ARVC-Darrhythmogenic right ventricular cardiomyopathy-dysplasia

IVSinter-ventricular septum

LVleft ventricle


ROIregion of interest

RVright ventricle

VTventricular tachycardia

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Author: Maria E. Campian - Hanno L. Tan - Astrid F. van Moerkerken - Raymond Tukkie - Berthe L. F. van Eck-Smit - Hein J. Ve


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