Reversible Left Ventricular Trabeculations in Pregnancy
Is This Sufficient to Make the Diagnosis of Left Ventricular Noncompaction?
Left ventricular noncompaction cardiomyopathy (LVNC) is a disorder characterized by significant ventricular trabeculations on cardiovascular imaging. The most common echocardiographic criteria used to define the disorder are the Jenni et al1 and Chin et al2 criteria. These criteria were developed after the observation that some patients, primarily children, had cardiomyopathies characterized by significant trabeculations associated with recesses. These criteria differ in that the Jenni et al criteria focus on comparing the noncompacted and compacted myocardium at end systole, whereas the Chin et al criteria compare the noncompacted and total myocardial thickness at end diastole. Diagnosis of noncompaction based on imaging studies is variable but in 1 large review was estimated to involve 0.24% of the general population.3 Trabeculations fulfilling the criteria for LVNC have been seen in a variety of individuals, including patients with sickle cell anemia, athletes, pregnant women, and patients with dilated cardiomyopathy.4–7 In a retrospective evaluation of patients with systolic heart failure, the number of patients fulfilling criteria for LVNC far exceeds (23.6%) that reported in the general population.7
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As explained in this issue of Circulation, because these disorders and pregnancy are associated with increased preload, Gati and colleagues8 believe that increased …