Journal of the American Society of Echocardiography
Clinical InvestigationCongenital Heart DiseaseReduced Left Ventricular Compacta Thickness: A Novel Echocardiographic Criterion for Non-Compaction Cardiomyopathy
Section snippets
Patients
Forty-one consecutive patients with definite diagnosis of LVNC were evaluated. The diagnosis of LVNC was established by echocardiography with strict adherence to previously published criteria comprising the following four conditions: (1) absence of coexisting cardiac abnormalities; (2) a two-layered myocardial wall with a compacted epicardial layer and a noncompacted endocardial layer, with a maximal end-systolic ratio of noncompacted to compacted layer > 2 in the parasternal short-axis view;
Patient Characteristics
A total of 41 patients (28 [68%] men) with LVNC, 41 age- and sex-matched controls, and 41 patients with hypertrophic myocardium due to moderate or severe AVS mean (left ventricular muscle mass index, 162 ± 7 g/m2) were analyzed. The mean age at presentation was 36 ± 16 years in patients with LVNC and 36 ± 16 years in controls; the mean age in patients with AVS was slightly higher (48 ± 12 years; P < .001 vs patients with LVNC and controls). In patients with LVNC, the most commonly involved
Discussion
Accurate diagnostic criteria for LVNC are important, because its clinical consequences include heart failure due to slowly progressive ventricular dysfunction, ventricular arrhythmias, and systemic embolism.13 However, the diagnosis of LVNC can be challenging despite the existence of echocardiographic criteria, because it is often difficult to apply the latter in clinical routine. The main reasons accounting for this are technical limitations, in particular poor echocardiographic windows and
Conclusions
Left ventricular compacta thickness represents a novel, simple, and robust criterion to diagnose LVNC and should be included in the list of diagnostic criteria for this cardiomyopathy. The criterion indicates that patients with LVNC, in contrast to those with normal or hypertrophic hearts, exhibit a maximal systolic compacta thickness <8 mm in the segment exhibiting the most prominent recesses. Hence, a compacta thickness >8.1 mm indicates either that the patient does not have LVNC or that an
References (21)
- et al.
Long-term follow-up of 34 adults with isolated left ventricular noncompaction: a distinct cardiomyopathy with poor prognosis
J Am Coll Cardiol
(2000) - et al.
Left ventricular hypertrabeculation/noncompaction and association with additional cardiac abnormalities and neuromuscular disorders
Am J Cardiol
(2002) - et al.
Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology
J Am Soc Echocardiogr
(2005) - et al.
Cardiac segmental analysis in left ventricular noncompaction: experience in a pediatric population
J Am Soc Echocardiogr
(2010) Left ventricular noncompaction: travelling the road from diagnosis to outcomes
J Am Soc Echocardiogr
(2010)- et al.
Isolated noncompaction of the myocardium in adults
Mayo Clin Proc
(1997) - et al.
Validation of noncompaction criteria in dilated cardiomyopathy, and valvular and hypertensive heart disease
J Am Soc Echocardiogr
(2005) - et al.
Isolated noncompaction of left ventricular myocardium. A study of eight cases
Circulation
(1990) - et al.
Left ventricular noncompaction and cardiomyopathy: cause, contributor, or epiphenomenon?
Curr Opin Cardiol
(2008) - et al.
Wide spectrum of presentation and variable outcomes of isolated left ventricular non-compaction
Heart
(2007)
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2020, IJC Heart and VasculatureCitation Excerpt :A second reason for the variability of results is the non-uniformity of LVNC criteria used. Not only do the studies mentioned vary with regard to the criteria used, but, since the publication of Kohli et al. in 2008, the individual criterion themselves have been modified—including those utilised by Jenni et al. and Stollberger et al [5,16–18,21]. Thus, the current criteria are more similar, more encompassing, and stricter.
Left-ventricular non-compaction–comparison between different techniques of quantification of trabeculations: Should the diagnostic thresholds be modified?
2020, Archives of Cardiovascular DiseasesCitation Excerpt :The criteria of Jenni et al. [11] are the most widely accepted, but were developed based upon pathological confirmation in only seven patients with LVNC, and the ratio between non-compacted and compacted layers in the most trabeculated area by definition cannot give a global view of the trabecular entity in all of the LV. In another small study, the criterion of maximal systolic compacta thickness of < 8.1 mm was found to be very specific for myocardial thickening in LVNC compared with normal controls or patients with aortic stenosis [27]. Similarly, the criterion of Chin et al. [8] was based upon observations from only eight patients, and is defined as the presence of X/Y ≤ 0.5, where X is the distance from the epicardial surface to the trough of the trabecular recess and Y is the distance from the epicardial surface to the peak of trabeculation, at the LV apex on subxiphoid or apical 4 C views at end-diastole.
Drs. Gebhard and Stähli contributed equally to this work.