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.

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