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Left ventricular non-compaction: clinical features and cardiovascular magnetic resonance imaging.

Yousef ZR, Foley PW, Khadjooi K, Chalil S, Sandman H, Mohammed NU, Leyva F - BMC Cardiovasc Disord (2009)

Bottom Line: The latter was quantified using planimetry on the two-chamber long axis LV view (NC area).At presentation, 50% had dyspnoea, 19% chest pain, 14% palpitations and 5% stroke.In patients without dyspnoea (n = 21), NC area correlated positively with end-diastolic volume (r = 0.52, p = 0.0184) and end-systolic volume (r = 0.56, p = 0.0095), and negatively with EF (r = -0.72, p = 0.0001).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology, Good Hope Hospital, Sutton Coldfield, West Midlands, UK. z@yousef.me.uk

ABSTRACT

Background: It is apparent that despite lack of family history, patients with the morphological characteristics of left ventricular non-compaction develop arrhythmias, thrombo-embolism and left ventricular dysfunction.

Methods: Forty two patients, aged 48.7 +/- 2.3 yrs (mean +/- SEM) underwent cardiovascular magnetic resonance (CMR) for the quantification of left ventricular volumes and extent of non-compacted (NC) myocardium. The latter was quantified using planimetry on the two-chamber long axis LV view (NC area). The patients included those referred specifically for CMR to investigate suspected cardiomyopathy, and as such is represents a selected group of patients.

Results: At presentation, 50% had dyspnoea, 19% chest pain, 14% palpitations and 5% stroke. Pulmonary embolism had occurred in 7% and brachial artery embolism in 2%. The ECG was abnormal in 81% and atrial fibrillation occurred in 29%. Transthoracic echocardiograms showed features of NC in only 10%. On CMR, patients who presented with dyspnoea had greater left ventricular volumes (both p < 0.0001) and a lower left ventricular ejection fraction (LVEF) (p < 0.0001) than age-matched, healthy controls. In patients without dyspnoea (n = 21), NC area correlated positively with end-diastolic volume (r = 0.52, p = 0.0184) and end-systolic volume (r = 0.56, p = 0.0095), and negatively with EF (r = -0.72, p = 0.0001).

Conclusion: Left ventricular non-compaction is associated with dysrrhythmias, thromboembolic events, chest pain and LV dysfunction. The inverse correlation between NC area and EF suggests that NC contributes to left ventricular dysfunction.

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Scattergrams of non-compacted (NC) area against left ventricular end-diastolic (LVEDV) and end-systolic (LVESV) volumes, and left ventricular ejection fraction (LVEF) in patients with left ventricular ventricular non-compaction who did not present with dyspnoea.
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Figure 4: Scattergrams of non-compacted (NC) area against left ventricular end-diastolic (LVEDV) and end-systolic (LVESV) volumes, and left ventricular ejection fraction (LVEF) in patients with left ventricular ventricular non-compaction who did not present with dyspnoea.

Mentions: As shown in Figure 3, NC myocardium was most frequently seen at the apex, followed by the apical septum, mid-septum, apical inferior wall, basal septum, mid-inferior and basal inferior walls. No significant differences emerged in the x:y ratio or NC area between patients presenting with dyspnoea and those without (see table S2 in additional file 2). In analyses of the whole study group, no correlation emerged between NC area and either LVEDV or LVESV. In the 21 patients without dyspnoea, however, NC area correlated positively with LVEDV (r = 0.52, p = 0.0184) and LVESV (r = 0.56, p = 0.0095) and negatively with LVEF (r = -0.72, p = 0.0001) (Figure 4).


Left ventricular non-compaction: clinical features and cardiovascular magnetic resonance imaging.

Yousef ZR, Foley PW, Khadjooi K, Chalil S, Sandman H, Mohammed NU, Leyva F - BMC Cardiovasc Disord (2009)

Scattergrams of non-compacted (NC) area against left ventricular end-diastolic (LVEDV) and end-systolic (LVESV) volumes, and left ventricular ejection fraction (LVEF) in patients with left ventricular ventricular non-compaction who did not present with dyspnoea.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2743643&req=5

Figure 4: Scattergrams of non-compacted (NC) area against left ventricular end-diastolic (LVEDV) and end-systolic (LVESV) volumes, and left ventricular ejection fraction (LVEF) in patients with left ventricular ventricular non-compaction who did not present with dyspnoea.
Mentions: As shown in Figure 3, NC myocardium was most frequently seen at the apex, followed by the apical septum, mid-septum, apical inferior wall, basal septum, mid-inferior and basal inferior walls. No significant differences emerged in the x:y ratio or NC area between patients presenting with dyspnoea and those without (see table S2 in additional file 2). In analyses of the whole study group, no correlation emerged between NC area and either LVEDV or LVESV. In the 21 patients without dyspnoea, however, NC area correlated positively with LVEDV (r = 0.52, p = 0.0184) and LVESV (r = 0.56, p = 0.0095) and negatively with LVEF (r = -0.72, p = 0.0001) (Figure 4).

Bottom Line: The latter was quantified using planimetry on the two-chamber long axis LV view (NC area).At presentation, 50% had dyspnoea, 19% chest pain, 14% palpitations and 5% stroke.In patients without dyspnoea (n = 21), NC area correlated positively with end-diastolic volume (r = 0.52, p = 0.0184) and end-systolic volume (r = 0.56, p = 0.0095), and negatively with EF (r = -0.72, p = 0.0001).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Cardiology, Good Hope Hospital, Sutton Coldfield, West Midlands, UK. z@yousef.me.uk

ABSTRACT

Background: It is apparent that despite lack of family history, patients with the morphological characteristics of left ventricular non-compaction develop arrhythmias, thrombo-embolism and left ventricular dysfunction.

Methods: Forty two patients, aged 48.7 +/- 2.3 yrs (mean +/- SEM) underwent cardiovascular magnetic resonance (CMR) for the quantification of left ventricular volumes and extent of non-compacted (NC) myocardium. The latter was quantified using planimetry on the two-chamber long axis LV view (NC area). The patients included those referred specifically for CMR to investigate suspected cardiomyopathy, and as such is represents a selected group of patients.

Results: At presentation, 50% had dyspnoea, 19% chest pain, 14% palpitations and 5% stroke. Pulmonary embolism had occurred in 7% and brachial artery embolism in 2%. The ECG was abnormal in 81% and atrial fibrillation occurred in 29%. Transthoracic echocardiograms showed features of NC in only 10%. On CMR, patients who presented with dyspnoea had greater left ventricular volumes (both p < 0.0001) and a lower left ventricular ejection fraction (LVEF) (p < 0.0001) than age-matched, healthy controls. In patients without dyspnoea (n = 21), NC area correlated positively with end-diastolic volume (r = 0.52, p = 0.0184) and end-systolic volume (r = 0.56, p = 0.0095), and negatively with EF (r = -0.72, p = 0.0001).

Conclusion: Left ventricular non-compaction is associated with dysrrhythmias, thromboembolic events, chest pain and LV dysfunction. The inverse correlation between NC area and EF suggests that NC contributes to left ventricular dysfunction.

Show MeSH
Related in: MedlinePlus