A cardiovascular magnetic resonance non-compacted to compacted myocardium ratio >2.3 in diastole distinguished pathological non-compaction with 86% sensitivity and 99% specificity.
Observational (n=177)
Does the ratio of non-compacted to compacted myocardium (NC/C ratio) measured by cardiovascular magnetic resonance accurately distinguish pathological left ventricular non-compaction from other conditions?
A non-compacted to compacted myocardium ratio >2.3 in diastole measured by cardiovascular magnetic resonance accurately distinguishes pathological left ventricular non-compaction from normal trabeculation and other cardiomyopathies.
OBJECTIVES: We aimed to test the diagnostic accuracy of cardiovascular magnetic resonance (CMR) imaging in distinguishing pathological left ventricular non-compaction (LVNC) from lesser degrees of trabecular layering seen in healthy volunteers and, in those with cardiomyopathies and concentric left ventricular hypertrophy, potential differential diagnoses. We hypothesized that pathological trabeculation could be distinguished by determining the ratio of non-compacted to compacted myocardium (NC/C ratio). BACKGROUND: Left ventricular non-compaction is characterized by a non-compacted myocardial layer in the left ventricle. Cardiovascular magnetic resonance images this layer with unprecedented quality, particularly in the ventricular apex, where echocardiography has inherent difficulties. METHODS: We analyzed magnetic resonance cine images, using the 17-segment model in 45 healthy volunteers, 25 athletes, 39 patients with hypertrophic cardiomyopathy and 14 with dilated cardiomyopathy, 17 with hypertensive heart disease, and 30 with aortic stenosis, as well as images from 7 patients previously diagnosed with LVNC whose diagnoses were supported by additional features. RESULTS: Areas of non-compaction were common and occurred more frequently in all groups studied in apical and lateral, rather than in basal or septal, segments. A NC/C ratio of >2.3 in diastole distinguished pathological non-compaction, with values for sensitivity, specificity, and positive and negative predictions of 86%, 99%, 75%, and 99%, respectively. CONCLUSIONS: Left ventricular non-compaction is diagnosed accurately with CMR using the NC/C ratio in diastole.
“We envisage the scientific community will move away from the term 'LV non-compaction', which is misleading, to use 'excessive trabeculation' which can be observed across a wide spectrum of health and disease states. The recommendation from this work has a substantial clinical impact as it can reduce harm to patients and people often wrongly labelled to have a specific disease. We also hope that this review article and expert consensus will lead to further research to better characterise the genetic basis and physiological impact of excessive trabeculation in otherwise normal individuals.”
Petersen et al. (Fri,) conducted a observational in Left ventricular non-compaction (n=177). Cardiovascular magnetic resonance (CMR) NC/C ratio >2.3 in diastole vs. Healthy volunteers and patients with other cardiac conditions was evaluated on Diagnostic accuracy for pathological non-compaction. A cardiovascular magnetic resonance non-compacted to compacted myocardium ratio >2.3 in diastole distinguished pathological non-compaction with 86% sensitivity and 99% specificity.