Abstract 3907: Left Ventricular Noncompaction: Caveats of Echocardiographic Criteria and Overlap With Other Cardiomyopathies
Background. Left ventricular (LV) noncompaction (LVNC) is characterized by a 2-layered myocardium with noncompacted myocardium, increased wall thickness, and trabeculations/recesses. Diagnostic criteria have been published by Jenni, Chin and Stöllberger et al. Many rely solely on a ratio of noncompacted: compacted myocardium >2:1 (at end-diastole, one of the Jenni criteria). Criteria published by Chin (ratio<0.5 at end-systole) and Stöllberger (at least 3 apical trabeculations; intertrabecular spaces) are also used. A recent study questioned the specificity of these criteria.
Methods. Prospective comparison of these criteria was made in 89 pt with either isolated LVNC (9 pt), dilated cardiomyopathy; (DCM;20), hypertensive heart disease (HHD; 20 pt), or hypertrophic cardiomyopathy (HCM; 20 pt) compared to controls (20 pt).
Results. LV ejection fraction was lower in DCM (32±11%) und LVNC (36±11%) compared to the other groups. Anomalous papillary muscles were most common in LVNC and HCM. LV wall thickening was most frequent in HHD, LVNC and HCM. Results of assessment with LVNC criteria are in the Table⇓.
Conclusions. The best diagnostic accuracy is achieved with the criteria by Jenni and Stöllberger. All published echocardiographic criteria for LVNC are not 100 % specific. Relying solely on the ratio of noncompacted/compacted myocardium is not reliable, wall thickening, meshwork and recess formation have to be considered. There is a considerable overlap of between LVNC with HCM. These caveats of echocardiographic diagnosis of LVNC have to be known.