Usefulness of speckle myocardial imaging modalities for differential diagnosis of left ventricular non-compaction of the myocardium

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• 作者：Marcelino Corté ; s^a ; ^{mcortes@secardiologia.es" class="auth_mail" title="E-mail the corresponding author} ; Marí ; a Reyes Oliva^b ; Miguel Orejas^a ; Miguel Angel Navas^a ; Rosa Marí ; a Rá ; bago^a ; Maria Esther Martí ; nez^a ; Mikel Taibo^a ; Julia Palfy^a ; Manuel Rey^a ; Jeró ; nimo Farré ; ^a
• 关键词：Non-compaction ; Speckle tracking ; Rotation ; Cardiomyopathy
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 November 2016
• 年：2016
• 卷：223
• 期：Complete
• 页码：813-818
• 全文大小：673 K

文摘

Current diagnostic criteria for left ventricular non-compaction (LVNC) may result in over-diagnosis of the disease. We evaluate the role of speckle imaging in differential diagnosis of LVNC.

Methods and results

We included all patients who, between January 2012 and May 2015, fulfilled currently accepted criteria for LVNC (28 patients). A control group of 28 healthy individuals and a third group of 13 patients with dilated cardiomyopathy (DCM) were created. Speckle-tracking echocardiography was performed in all groups. Thirteen patients with LVNC had an ejection fraction (EF) < 50% (33.5%, SD 10). When compared to controls, patients with LVNC and EF < 50% had a larger LV, larger left atrial diameter (LA), reduced e′, and reduced global longitudinal strain (GLS). All but one patient with LVNC and EF < 50% showed an abnormal LV rotation. This abnormal pattern was observed in 4 LVNC patients (27%) with EF ≥ 50% and in none of the controls. In patients with LVNC, EF ≥ 50%, and abnormal rotation, GLS was lower than in controls, (− 17 (SD 3) vs − 21 (SD 3)). Rigid body rotation (RBR) was also observed in 2 DCM patients, with significant differences in EF, GLS, LV diameters relative to the rest of the DCM group.

Conclusions

In patients who fulfil the morphologic criteria for LVNC, speckle myocardial imaging techniques could be useful in differentiating between healthy individuals (functionally normal LV) and patients with LVNC (with functional abnormalities in the myocardium in spite of a preserved EF).