Left ventricular characteristics of noncompaction phenotype patients with good ejection fraction measured with cardiac magnetic resonance

Abstract

Objective: We describe left ventricular (LV) volumes, myocardial and trabeculated muscle mass and strains with Cardiac magnetic resonance of a large cohort (n=81) who fulfilled the morphologic criteria of left ventricular noncompaction (LVNC) and had good ejection fraction (EF >55%) and compare them with healthy controls (n=81). Male and female patients were compared to matched controls and to each other. We also investigated the LV trabeculated muscle mass cutoff in male and female patients with LVNC. Methods: 81 participants with LVNC and 81 healthy controls were included. Male and female patients were compared to matched controls and to each other. We also investigated the left ventricular trabeculated muscle mass cut-off in male and female LVNC patients. Results: The LV parameters of the LVNC population were normal, but they had significantly higher volumes, myocardial and trabeculated muscle mass, and a significantly smaller EF than the controls. Similar differences were observed after stratifying by sex. The optimal LV trabeculated muscle mass cutoffs were 25.8 g/m 2 in men (area under the curve: 0.81) and 19.0 g/m 2 in women (area under the curve: 0.87). The patients had normal global strains but a significantly worse global circumferential strain (patients vs controls: −29.9±4.9 vs. −35.8±4.7%, p<0.05) and significantly higher circumferential mechanical dispersion than the controls (patients vs. controls: 7.6±4.2 vs. 6.1±2.8%; p<0.05). No diseaserelated strain differences were noted between men and women. Conclusion:The LV functional and strain characteristics of the LVNC cohort differed significantly from those of healthy participants; this might be caused by increased LV trabeculation, and its clinical relevance might be questionable. The LV trabeculated muscle mass was very different between men and women; thus, the use of sex-specific morphologic diagnostic criteria should be considered.

Pathophysiology of Non-compaction Remains Enigmatic

“… 1 It was concluded that LV functional and strain characteristics of the LVHT cohort differ 2 significantly from healthy controls. 1 Since the LV muscle mass was larger in men as compared to females, gender-specific diagnostic criteria are warranted. 1 We have the following comments and concerns.…”

“… 1 Left ventricular hypertrabeculation patients nonetheless had increased LV volume, LV mass, reduced LV ejection fraction, and reduced global circumferential strain. 1 It was concluded that LV functional and strain characteristics of the LVHT cohort differ 2 significantly from healthy controls. 1 Since the LV muscle mass was larger in men as compared to females, gender-specific diagnostic criteria are warranted.…”

“…With interest, we read the article by Kiss et al 1 about cardiac magnetic resonance imaging parameters in 81 patients with left ventricular non-compaction, also known as left ventricular hypertrabeculation (LVHT), but with normal left ventricular (LV) indices. 1 Left ventricular hypertrabeculation patients nonetheless had increased LV volume, LV mass, reduced LV ejection fraction, and reduced global circumferential strain. 1 It was concluded that LV functional and strain characteristics of the LVHT cohort differ 2 significantly from healthy controls.…”

“… 1 Since the LV muscle mass was larger in men as compared to females, gender-specific diagnostic criteria are warranted. 1 We have the following comments and concerns.…”

Reply to letter to the editor: “Pathophysiology of Non-compaction Remains Enigmatic”

“…We would like to thank you for the opportunity to reply to the comments and concerns raised in the author’s letter to the Editor and to give details about the patient population included in our study. 1 We would also like to thank the author for his interest in our paper and for taking the time to express their concerns.…”