Abstract 14517: Regional Reduction of Systolic Compacta Thickness Helps to Distinguish Isolated Left Ventricular Non-Compaction From Dilated Cardiomyopathy Using Cardiac Magnetic Resonance Imaging
Background: Marked trabeculation, chamber dilation and ventricular contractile impairment are presented in left ventricular non-compaction (LVNC) and dilated cardiomyopathy (DCM), which sometimes makes the diagnosis difficult. We hypothesized that regional analysis of systolic compacta thickness would help to differentiate them.
Objective: To measure the systolic compacta thickness in left ventricle using cardiac magnetic resonance and assess its value in the diagnosis of LVNC.
Methods: From December 2008 to April 2013, twenty-one patients (10 males; 43.2±15.6 years), who fulfilled the Peterson CMR criteria of isolated LVNC, and 22 patients with DCM (14 males; 50.5±18.9 years) were enrolled. Chamber diameters and ventricular ejection fractions (EF) were measured. The maximal systolic compacta thickness of each segment was assessed using the 17-segment model. All patients were followed up for 27.4±20.6 months.
Results: The gender, onset age, right ventricular EF, and incidence of complication events including ventricular arrhythmias, thromboembolism and cardiac death were similar in both groups. Patients with DCM had markedly lower left ventricular EF values (DCM 28.0±13.4% vs. LVNC 43.2±15.6%, p<0.05). The maximal systolic compacta thickness in apical anterior (LVNC 7.9±1.7 mm vs. DCM 10.1±2.9 mm), apical inferior (LVNC 7.8±2.0 mm vs. DCM 9.4±3.2 mm) and apical lateral segments (LVNC 9.8±3.2 mm vs. DCM 11.6±2.3 mm) was significantly reduced in LVNC group (all p<0.05), but spared mid-ventricular and basal segments. When standardized by body surface area, maximal systolic compacta thickness in apical anterior and lateral segments remained significantly reduced in LVNC group. The area under the Receiver Operating Characteristics curve of the apical anterior segment was 0.83 (95% CI: 0.70-0.95). With a cutoff value of 8.5 mm, the sensitivity, specificity, positive and negative likelihood ratios for LVNC were 76.2%, 77.3%, 3.36 and 0.31 respectively.
Conclusion: Patients with LVNC presented better left ventricular systolic function than DCM. Maximal systolic compacta thickness was significantly reduced in the apical regions of LVNC, especially the anterior segment, which seemed to provide help for the differentiation of LVNC and DCM.
- © 2013 by American Heart Association, Inc.