The use of 2-D speckle tracking echocardiography in assessing adolescent athletes with left ventricular hypertrabeculation meeting the criteria for left ventricular non-compaction cardiomyopathy

Dorobantu, Dan Mihai; Radulescu, Cristina R.; Riding, Nathan R; McClean, Gavin; Garza, María-Sanz de la; Abuli-Lluch, Marc; Duarte, Nuno; Adamuz, Maria Carmen; Ryding, Diane; Perry, Dewayne E.; McNally, Steve; Stuart, A. Graham; Sitges, Marta; Oxborough, David; Wilson, Mathew G; Williams, Craig A.; Pieles, Guido

doi:10.1016/j.ijcard.2022.09.076

Cited by 5 publications

(3 citation statements)

References 34 publications

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“…Accordingly, we present new paediatric-athlete-specific LVEF Z-scores to account for this sluggish pump patten. LVEF, however, assesses only radial function, with longitudinal functional impairment often preceding radial systolic dysfunction, allowing for differentiation between athlete’s heart and inherited cardiomyopathies [ 29 , 30 ]. Limitations highlighted by investigations in pathological hypertensive patients diagnosed with heart failure, but with preserved EF [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

A New Tool to Aid the Differential Diagnosis of Physiological Remodelling from Cardiac Pathology When Assessing Left Ventricle, Left Atrial and Aortic Structure and Function in Male Arab and Black Paediatric Athletes

McClean

Wilson

Riding

et al. 2023

JCDD

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Aim: To determine if published Z-scores for left ventricular (LV), left atrial (LA) and aortic structure as well as indices of LV function (Doppler and TDI) in paediatric athletes and non-athletes are appropriate for application in male Arab and black paediatric athletes. If inappropriate, we aim to provide new nomograms and Z-scores for clinical application. Methods: 417 (297 Arab, 120 black) male paediatric (11–18 years) athletes, were evaluated by 2D echocardiography as per British Society of Echocardiography recommendations, and biological age (by radiological X-ray) assessment. Z-scores were tested by residual and correlation analysis together with visual inspection. New Z-scores involved allometric (a*BSA(b+c*chronological age)) and second-order polynomial (y=a*chronological age2+b*chronological age+c) equations for measures of cardiac size and indices of LV function, respectively. Results: Residual linear regression, correlation analysis and visual inspection revealed published z-scores in white peri-pubertal footballers and paediatric non-athletes to be inappropriate for application in male Arab and black paediatric athletes. Residual linear regression revealed new Z-scores for measures of LV, LA and aortic root size to be independent of BSA, ethnicity, chronological and biological age. Residual linear regression revealed new Z-scores for measures of function to be independent of chronological age. Conclusion: Our new z-scores may aid differential diagnosis of suspected pathology versus physiology remodelling, in cardiac screening of the Arab and black paediatric athlete. Nomograms are provided to assist the tracking of the paediatric athlete necessitating annual follow-up and Excel z-score calculation to facilitate use in day-to-day practice.

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Section: Discussionmentioning

confidence: 99%

A New Tool to Aid the Differential Diagnosis of Physiological Remodelling from Cardiac Pathology When Assessing Left Ventricle, Left Atrial and Aortic Structure and Function in Male Arab and Black Paediatric Athletes

McClean

Wilson

Riding

et al. 2023

JCDD

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“…In a recent study, LV rotational parameters of healthy adolescent athletes meeting Jenni’s criteria for LVNC were not worse compared to those who did not meet the criteria [ 71 ]. LV twist was found to be significantly reduced in young patients with LVNC compared with controls and those with LV hypertrabeculation, and reduced LV twist was an independent predictor of LVNC [ 72 ].…”

Section: The Left Heart and The Aortamentioning

confidence: 99%

Myocardial Mechanics and Associated Valvular and Vascular Abnormalities in Left Ventricular Noncompaction Cardiomyopathy

Nemes

2023

JCM

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Left ventricular (LV) non-compaction (LVNC) is a rare genetic cardiomyopathy due to abnormal intra-uterine arrest of compaction of the myocardial fibers during endomyocardial embryogenesis. Due to the partial or complete absence of LV compaction, the structure of the LV wall shows characteristic abnormalities, including a thin compacted epicardium and a thick non-compacted endocardium with prominent trabeculations and deep intertrabecular recesses. LVNC is frequently associated with chronic heart failure, life-threatening ventricular arrhythmias, and systemic embolic events. According to recent findings, in the presence of LVNC, dysfunctional LV proved to be associated with left atrial volumetric and functional abnormalities and consequential dilated and functionally impaired mitral annulus, partly explaining the higher prevalence of regurgitation. Although the non-compaction process morphologically affects only the LV, signs of remodeling of the right heart were also detected. Moreover, dilation and stiffening of the aorta were present. The aim of the present detailed review was to summarize findings regarding changes in cardiac mechanics, valvular abnormalities, and vascular remodeling detected in patients with LVNC.

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“…To evaluate whether the strain parameters in mTFC+ subjects were comparable to mTFC-subjects, a non-inferiority statistical approach was chosen, used previously. [26] The "two one-sided t-test" (TOST package) [27] was used, which determines whether the difference between 2 means is between a lower and upper set limit (equivalence limit or delta). This limit was empirically chosen, based on available data, [13,28] to be 2% for S l and proportionally, 0.1 s − 1 for SR l , these values being also <10% of the cohort means and less than one SD.…”

Section: Statistical Analysesmentioning

confidence: 99%

The use of 2-D speckle tracking echocardiography in differentiating healthy adolescent athletes with right ventricular outflow tract dilation from patients with arrhythmogenic cardiomyopathy

Dorobantu¹,

Riding²,

McClean³

et al. 2023

International Journal of Cardiology

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The use of 2-D speckle tracking echocardiography in assessing adolescent athletes with left ventricular hypertrabeculation meeting the criteria for left ventricular non-compaction cardiomyopathy

Cited by 5 publications

References 34 publications

A New Tool to Aid the Differential Diagnosis of Physiological Remodelling from Cardiac Pathology When Assessing Left Ventricle, Left Atrial and Aortic Structure and Function in Male Arab and Black Paediatric Athletes

A New Tool to Aid the Differential Diagnosis of Physiological Remodelling from Cardiac Pathology When Assessing Left Ventricle, Left Atrial and Aortic Structure and Function in Male Arab and Black Paediatric Athletes

Myocardial Mechanics and Associated Valvular and Vascular Abnormalities in Left Ventricular Noncompaction Cardiomyopathy

The use of 2-D speckle tracking echocardiography in differentiating healthy adolescent athletes with right ventricular outflow tract dilation from patients with arrhythmogenic cardiomyopathy

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