A multi-center cohort study of patients in China with arrhythmogenic cardiomyopathy (ACM) is contributing important insights into understanding the disease and the unique genetic and clinical characteristics that manifest in Chinese patients, according to an overview published in JACC: Asia and being discussed at ACC Asia 2025 in Singapore.

According to Yuxiao Hu, MD; Zhongli Chen, MD, PhD, et al., the ChinaCORE ACM Registry is tracking medical history, cardiac evaluations, and genetic information in patients with definite or borderline ACM diagnoses, along with their genotype-positive relatives. As of September 2024, the registry had enrolled more than 600 participants, including 552 probands (88.7%) and 70 family members (11.3%) carrying ACM-related variants.

According to early data from 577 of these participants, the median age of symptom onset was 33 years, with 41.6% experiencing arrhythmia-related symptoms. The study authors also found that abnormal ECG findings included T-wave inversion (72.7%) and epsilon waves (24.8%) in leads V1–V3, while imaging evaluations revealed RV dilatation in 44.6% and LV dilatation in 29.8%, with a mean LVEF of 53.0 ± 14.5%.

In other findings, malignant ventricular arrhythmias occurred in roughly 40% of individuals, while approximately 22% developed end-stage heart failure. There were 35 heart failure-related deaths, while 101 individuals underwent heart transplantation, noted Hu and colleagues.

"This study not only collected traditional prognostic indicators, including demographic characteristics and medical history, but also comprehensively gathered emerging potential risk factors, such as parameters from ECG, echocardiography, CMR, plasma biomarkers and genetic characteristics," the authors wrote. "Eventually, critical prognostic factors will be determined, and the prediction models for malignant ventricular arrhythmias and end-stage heart failure outcomes will be built."