Prognostic Value of Right Ventricular 3D Trabecular Complexity in Arrhythmogenic right ventricular cardiomyopathy

Motivation: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by progressive myocardial fibro-fatty infiltration accompanied by trabecular disarray. The prognostic value of trabecular disorder assessed by three-dimensional (3D) fractal dimension (FD) measurement is unclear. Goal(s): To investigate the prognostic value of 3D right ventricular trabecular complexity of ARVC. Approach: Using cine images, trabecular complexity was measured with 3D fractal analysis to calculate 3D-FD in ARVC patients retrospectively. Cox regression analyses and Kaplan-Meier survival analysis were performed to identify the prognostic value of 3D-FD. Results: RV 3D-FD was a significant risk predictor for MACE in ARVC and provided incremental prognostic value to conventional predictors. Impact: Based on the results, we suggested 3D RV trabecular complexity, derived from non-invasive imaging examination, as a new biomarker for early clinical therapy in medication and ICD implantation in order to moderate the onset of adverse endpoints in ARVC patients.