Characteristics of Trabeculated Myocardium Burden in Young and Apparently Healthy Adults

Tizón‐Marcos, Helena; Ricapito, María de la Paz; Bertrand, Olivier; Bibeau, Karine; Ven, Florent Le; Sinha, Swapnil; Engert, James C.; Bédard, Élisabeth; Pasian, Sergio; Deschepper, Christian F.; Larose, Éric

doi:10.1016/j.amjcard.2014.07.025

Cited by 21 publications

(18 citation statements)

References 30 publications

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“…The control group consisted of subjects aged 18–35 years and free of any congenital or acquired cardiovascular disease, hypertension, dyslipidaemia, diabetes or renal, hepatic or blood disorders that were prospectively recruited in a previous study, which aimed at establishing normal reference values for CMR 23. LVNC criteria were assessed in a subset of the subjects included in this previous CMR study 24. The study was approved by the institution ethics board and informed consent was obtained for subjects who were recruited prospectively and consent was waived for the BAV subjects who were assessed retrospectively.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of left ventricle non-compaction criteria in adult patients with bicuspid aortic valve versus healthy control subjects

et al. 2018

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ObjectiveThe aim of this study was to compare the prevalence of left ventricle non-compaction (LVNC) criteria (or hypertrabeculation) in a cohort of patients with bicuspid aortic valve (BAV) and healthy control subjects (CTL) without cardiovascular disease using cardiovascular MR (CMR).Methods79 patients with BAV and 85 CTL with tricuspid aortic valve and free of known cardiovascular disease underwent CMR to evaluate the presence of LVNC criteria. The left ventricle was assessed at end-systole and end-diastole, in the short-axis, two-chamber and four-chamber views and divided into the 16 standardised myocardial segments. LVNC was assessed using the non-compacted/compacted (NC/C) myocardium ratio and was considered to be present if at least one of the myocardial segments had a NC/C ratio superior to the cut-off values defined in previous studies: Jenni et al (>2.0 end-systole); Petersen et al (>2.3 end-diastole); or Fazio et al (>2.5 end-diastole).Results15 CTL (17.6%) vs 8 BAV (10.1%) fulfilled Jenni et al’s criterion; 69 CTL (81.2%) vs 49 BAV (62.0%) fulfilled Petersen et al’s criterion; and 66 CTL (77.6%) vs 43 BAV (54.4%) fulfilled Fazio et al’s criterion. Petersen et al and Fazio et al’s LVNC criteria were met more often by CTL (p=0.006 and p=0.002, respectively) than patients with BAV, whereas this difference was not statistically significant according to Jenni et al’s criterion (p=0.17). In multivariable analyses, after adjusting for age, sex, the presence of significant valve dysfunction (>mild stenosis or >mild regurgitation), indexed LV mass, indexed LV end-diastolic volume and LV ejection fraction, BAV was not associated with any of the three LVNC criteria.ConclusionPatients with BAV do not harbour more LVNC than the general population and there is no evidence that they are at higher risk for the development of LVNC cardiomyopathy.

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Section: Methodsmentioning

confidence: 99%

Prevalence of left ventricle non-compaction criteria in adult patients with bicuspid aortic valve versus healthy control subjects

et al. 2018

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“…It is characterized by a two-layered structure consisting of prominent trabeculations and inter-trabecular recesses [2–4]. The mechanistic basis for this cardiomyopathy remains controversial but it is thought to be secondary to an early fetal arrest of myocardial development with lack of compaction of the myocardial meshwork [2,3,5–7].…”

Section: Introductionmentioning

confidence: 99%

Noncompaction cardiomyopathy and heterotaxy syndrome

Martinez

Ware

Schamberger

et al. 2017

Progress in Pediatric Cardiology

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Left ventricular noncompaction cardiomyopathy (LVNC) is characterized by compact and trabecular layers of the left ventricular myocardium. This cardiomyopathy may occur with congenital heart disease (CHD). Single cases document co-occurrence of LVNC and heterotaxy, but no data exist regarding the prevalence of this association. This study sought to determine whether a non-random association of LVNC and heterotaxy exists by evaluating the prevalence of LVNC in patients with heterotaxy. In a retrospective review of the Indiana Network for Patient Care, we identified 172 patients with heterotaxy (69 male, 103 female). Echocardiography and cardiac magnetic resonance imaging results were independently reviewed by two cardiologists to ensure reproducibility of LVNC. A total of 13/172 (7.5%) patients met imaging criteria for LVNC. The CHD identified in this subgroup included atrioventricular septal defects [11], dextrocardia [10], systemic and pulmonary venous return abnormalities [7], and transposition of the great arteries [5]. From this subgroup, 61% (n = 8) of the patients developed arrhythmias; and 61% (n = 8) required medical management for chronic heart failure. This study indicates that LVNC has increased prevalence among patients with heterotaxy when compared to the general population (0.014–1.3%) suggesting possible common genetic mechanisms. Interestingly, mice with a loss of function of Scrib or Vangl2 genes showed abnormal compaction of the ventricles, anomalies in cardiac looping, and septation defects in previous studies. Recognition of the association between LVNC and heterotaxy is important for various reasons. First, the increased risk of arrhythmias demonstrated in our population. Secondly, theoretical risk of thromboembolic events remains in any LVNC population. Finally, many patients with heterotaxy undergo cardiac surgery (corrective and palliative) and when this is associated with LVNC, patients should be presumed to incur a higher peri-operative morbidity based on previous studies. Further research will continue to determine long-term and to corroborate genetic pathways.

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“…A further study by the MESA investigators showed that using NC/C threshold ratio >2.3 led to an incorrect diagnosis of LVNC in 706 of 2742 (25.7%) participants without any known cardiac disease [14]. Furthermore, only in the number of negligible patients, noncompacted myocardium headed to changes in left ventricular parameters over ten years [13,14]. Fazio et al, also questioned the over sensitivity of the NC/C wall threshold ratio and proposed to use > 2.5 cutoff threshold value for the diagnosis of LVNC on CMRI [19].…”

Section: Discussionmentioning

confidence: 99%

“…The authors suggested the re-evaluation of the criteria [13]. A further study by the MESA investigators showed that using NC/C threshold ratio >2.3 led to an incorrect diagnosis of LVNC in 706 of 2742 (25.7%) participants without any known cardiac disease [14]. Furthermore, only in the number of negligible patients, noncompacted myocardium headed to changes in left ventricular parameters over ten years [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…Despite it is being extensively used in daily practice owing to its practicality and high inter-observer variability, several authors have raised concerns regarding the reliability of Petersen's criteria [13,14]. Much of the debate has gathered around the specificity of the approach, and several authors claimed that using NC/C > 2.3 might lead to overdiagnosis of LVNC [13,14]. The aim of the study was twofold: (1) to test the diagnostic accuracy of the criterion, NC/C wall threshold ratio > 2.3 on CMRI for the diagnosis of LNVC, and (2) to explore whether a refined cut-off value with higher diagnostic accuracy could be established on CMRI.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of noncompacted-to-compacted wall ratio criteria on CMRI for the diagnosis of left ventricular noncompaction

Aliş¹,

Şahin²,

Güler³

et al. 2019

Marmara Medical Journal

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Objectives: To investigate the diagnostic accuracy of the current criterion, noncompacted-to-compacted (NC/C) wall ratio > 2.3 on cardiac magnetic resonance imaging (CMRI) for the diagnosis of left ventricular noncompaction (LVNC). Materials and Methods: We retrospectively enrolled 37 patients as an LVNC group and a total of 97 participants with ischemic, hypertrophic, and dilated cardiomyopathy and healthy controls as a control group. The NC/C ratio was measured perpendicularly on short-axis cine images for segments 1-16 and four-chamber cine images for the apex during the end-diastole. The sensitivity, specificity, and diagnostic accuracy of NC/C ratio > 2.3 for the diagnosis of LVNC were calculated. Results: LVNC patients comprised 24 males (64.8%) and 13 females (35.2%) with the mean age of 29.24 ± 11.79 years. The NC/C ratio > 2.3 detected in all but one of the LVNC patients (97.3%). On the other hand, the specificity of NC/C ratio > 2.3 was 79.4% for the diagnosis of the LVNC patients. Using NC/C ratio > 2.66 and > 2.8 yielded 91.9% sensitivity and 97% specificity, and 81% sensitivity and 100% specificity, respectively. Conclusion: NC/C ratio > 2.3 might lead to overdiagnosis of LVNC. We suggest using higher NC/C cutoff value in individuals without high clinical suspicion of LVNC.

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Characteristics of Trabeculated Myocardium Burden in Young and Apparently Healthy Adults

Cited by 21 publications

References 30 publications

Prevalence of left ventricle non-compaction criteria in adult patients with bicuspid aortic valve versus healthy control subjects

Prevalence of left ventricle non-compaction criteria in adult patients with bicuspid aortic valve versus healthy control subjects

Noncompaction cardiomyopathy and heterotaxy syndrome

Diagnostic accuracy of noncompacted-to-compacted wall ratio criteria on CMRI for the diagnosis of left ventricular noncompaction

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