Athlete's Heart or Arrhythmogenic Right Ventricular Cardiomyopathy: Contribution of Exercise Cardiovascular Magnetic Resonance (CMR)

Study Overview
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Brief Summary
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Prospective, nonrandomized, single-center, comparative study to define if right ventricular (RV) contractile reserve assessed by exercise CMR helps to improve the differential diagnosis between pathological and physiological remodeling of the RV; ie. arrhythmogenic right ventricular cardiomyopathy (ARVC) and athlete's heart.

Detailed Description
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Comparison of the RV contractile reserve in 4 groups of patients: Arrhythmogenic right ventricular cardiomyopathy (ARVC) patients; endurance athletes with a dilated RV, endurance athletes with normal RV, untrained subject with normal RV. Patients will come to the hospital for 3 visits (3 half days): Visit 1: clinical evaluation, rest ECG, rest echocardiography, cardio-pulmonary exercise test. Visit 2: exercise echocardiography, holter ECG monitor (48 yours) Visit 3: rest CMR and exercise CMR (ergocycle)

Official Title
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Athlete's Heart or Arrhythmogenic Right Ventricular Cardiomyopathy: Contribution of Exercise Cardiovascular Magnetic Resonance (CMR)

Conditions
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Arrhythmogenic Right Ventricular Cardiomyopathy

Intervention / Treatment
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* Other: Cardiac exercises and tests


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men or women aged 18 years and older, patients with confirmed ARVC, but with no major RV dysfunction (RVEF >40%) endurance athletes with dilated RV endurance athletes with non-dilated RV untrained healthy subjects with non-dilated RV who signed a written free and informed consent: Exclusion Criteria: Patients with other cardiovascular disease; Contra-indication to CMR (in particular presence of a non-CMR compatible implantable cardiac defibrillator); Patients with permanent supraventricular arrhythmia; Patients unable to perform an exercise test on an ergocycle; Person subject to legal protection (safeguard justice, trusteeship and guardianship) and persons deprived of liberty

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ARVC patients<br> | Other: Cardiac exercises and tests<br>* Rest ECG, rest echocardiography, cardio-pulmonary exercise test, exercise echocardiography, holter ECG monitor (48 yours), rest CMR, exercise CMR (ergocycle)<br>|
| Active Comparator: Endurance athletes with a dilated RV<br> | Other: Cardiac exercises and tests<br>* Rest ECG, rest echocardiography, cardio-pulmonary exercise test, exercise echocardiography, holter ECG monitor (48 yours), rest CMR, exercise CMR (ergocycle)<br>|
| Active Comparator: Endurance athletes with normal RV<br> | Other: Cardiac exercises and tests<br>* Rest ECG, rest echocardiography, cardio-pulmonary exercise test, exercise echocardiography, holter ECG monitor (48 yours), rest CMR, exercise CMR (ergocycle)<br>|
| Experimental: Untrained subject with normal RV<br> | Other: Cardiac exercises and tests<br>* Rest ECG, rest echocardiography, cardio-pulmonary exercise test, exercise echocardiography, holter ECG monitor (48 yours), rest CMR, exercise CMR (ergocycle)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evolution of right ventricular ejection fraction (RVEF) assessed with CMR during exercise |  | Through study completion, an average of 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evolution of Tricuspid annular plane systolic excursion (TAPSE) during exercise |  | Through study completion, an average of 1 month | 
| Evolution of S' tricuspid wave during exercise |  | Through study completion, an average of 1 month | 
| Evolution of RV fractional area during exercise |  | Through study completion, an average of 1 month | 
| Evolution of free wall RV strain during exercise |  | Through study completion, an average of 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ARVC, Athlete's heart, exercise, CMR, RV contractile reserve