The present modifications of the Task Force Criteria represent a working framework to improve the diagnosis and management of this condition. Clinical Trial Registration clinicaltrials.gov Identifier: NCT00024505.
In order to establish reference equations for prediction of the total distance walked during six minutes (6MWD) for healthy adults, we administered the standardized 6-min walk test to 117 healthy men and 173 healthy women, aged 40 to 80 yr. Oxygen saturation (SaO2), pulse rate, and the degree of dyspnea (Borg scale) were determined before and at the end of the walk. The median distance walked was 576 m for men and 494 m for women. The 6MWD was significantly less for men and women who were older and heavier, and for shorter men. The resulting gender-specific regression equations explained about 40% of the variance in the distance walked for healthy adults: for men, 6MWD = (7.57 x heightcm) - (5.02 x age) - (1.76 x weightkg) - 309 m, and for women, 6MWD = (2.11 x heightcm) - (2.29 x weightkg) - (5.78 x age) + 667 m. These reference equations may be used to compute the percent predicted 6MWD for individual adult patients performing the test for the first time, when using the standardized protocol.
Background—
In 1994, an International Task Force proposed criteria for the clinical diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) that facilitated recognition and interpretation of the frequently nonspecific clinical features of ARVC/D. This enabled confirmatory clinical diagnosis in index cases through exclusion of phenocopies and provided a standard on which clinical research and genetic studies could be based. Structural, histological, electrocardiographic, arrhythmic, and familial features of the disease were incorporated into the criteria, subdivided into major and minor categories according to the specificity of their association with ARVC/D. At that time, clinical experience with ARVC/D was dominated by symptomatic index cases and sudden cardiac death victims—the overt or severe end of the disease spectrum. Consequently, the 1994 criteria were highly specific but lacked sensitivity for early and familial disease.
Methods and Results—
Revision of the diagnostic criteria provides guidance on the role of emerging diagnostic modalities and advances in the genetics of ARVC/D. The criteria have been modified to incorporate new knowledge and technology to improve diagnostic sensitivity, but with the important requisite of maintaining diagnostic specificity. The approach of classifying structural, histological, electrocardiographic, arrhythmic, and genetic features of the disease as major and minor criteria has been maintained. In this modification of the Task Force criteria, quantitative criteria are proposed and abnormalities are defined on the basis of comparison with normal subject data.
Conclusions—
The present modifications of the Task Force Criteria represent a working framework to improve the diagnosis and management of this condition.
Clinical Trial Registration—
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00024505.
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