Key result
Low-dose CCT accurately diagnoses LVNC using a diastolic noncompacted to compacted layer ratio of ≥1.8.
Why the study?
The echocardiographic noncompacted to compacted myocardium ratio is difficult to assess in many patients with LVNC, prompting evaluation of cardiac computed tomography for diagnosis.
Does cardiac computed tomography accurately diagnose left ventricular non-compaction compared to transthoracic echocardiography?
Case-Control (n=36)
Blinded readers
No
Does cardiac computed tomography accurately diagnose left ventricular non-compaction compared to transthoracic echocardiography?
Effect estimate: AUC 0.997
ECG-triggered low-dose cardiac computed tomography can accurately diagnose left ventricular non-compaction using a diastolic NC:C ratio of ≥1.8, correlating strongly with echocardiography.
May aid LVNC assessment via CCT when TTE limited; leaves open prospective outcome validation before practice change.
PURPOSE: Left ventricular non-compaction (LVNC) is characterized by a 2-layered myocardium composed of a noncompacted (NC) and a compacted (C) layer. The echocardiographic NC:C ratio is difficult to assess in many patients. The aim of the study was to assess the value of cardiac computed tomography (CCT) for the diagnosis of LVNC. METHODS: In this prospective controlled study, segmental analysis of transthoracic echocardiography (TTE) and prospective ECG-triggered CCT was performed in 17 patients with LVNC and 19 healthy controls. In TTE maximal NC and C thickness was measured at enddiastole and endsystole in the segment with most prominent trabeculation in short axis views. In CCT, maximal segmental NC and C thickness was measured during diastole, and NC:C ratio was determined. Spearman's correlation coefficient and receiver operating characteristic curves were calculated. RESULTS: The median [IQR] radiation dose was 1.3[1.2-1.5]mSv. The CCT thickness of the C layer was significantly lower in patients with LVNC as compared to controls in the inferolateral, midventricular, lateral-, inferior-, and septal-apical segments. The CCT NC:C ratio differed significantly between LVNC and controls in the inferior-midventricular and all the apical segments. NC:C ratio correlated significantly between TTE and CCT at enddiastole (σ = 0.8) and endsystole (σ = 0.9). Using a CCT NC:C ratio ≥1.8, all LVNC patients could be identified. CONCLUSION: LVNC can be diagnosed with ECG-triggered low-dose CCT and discriminated from normal individuals using a NC:C ratio of ≥1.8 in diastole. There is a very good correlation of NC:C ratio in TTE and CCT.
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Fuchs et al. (2020) conducted a case-control in Left ventricular non-compaction (LVNC) (n=36). Cardiac computed tomography (CCT) vs. Healthy controls was evaluated on Detection of an affected LVNC segment using CCT NC:C ratio (AUC 0.997). Prospective ECG-triggered low-dose cardiac computed tomography accurately diagnosed left ventricular non-compaction using a diastolic noncompacted to compacted layer ratio of ≥1.8 (AUC 0.997).
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