Comparison of cardiac magnetic resonance imaging features of isolated left ventricular non-compaction in adults versus dilated cardiomyopathy in adults

Cheng, Huaibing; Zhao, Shihua; Jiang, Shiliang; Lü, Ming-De; Yan, Chaowu; Ji, Ling; Zhang, Y.; Liu, Q.; Ma, Ning; Yin, Gang; Wan, Jian; Yang, Yuejin; Li, L.; Jerec̆ić, Renate; He, Zhaoyi

doi:10.1016/j.crad.2011.04.014

Cited by 22 publications

(16 citation statements)

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“…Previous research shows the pathological changes of LVNC's noncompaction myocardial fibers are hypertrophy and derangement distribution; the compaction myocardial structure is normal . However, DCM's LV myocardial fiber is homogeneous hypertrophy but still neatly arranged . This is why tissue tracking may be an indicator for reflecting the subtle difference in myocardial deformation between the two cohorts.…”

Section: Discussionmentioning

confidence: 99%

“…Myocardial compaction progress develops from the epicardium to the endocardium and from the ventricular base to the apex; thus, the ventricle apical endocardium is prone to development arrest of the compaction process . Some scholars believe that the pathogenesis of excessive trabecularization in DCM is due to thickness of the myocardium and is not enough to compensate for the damaged myocardium . Therefore, the heart itself tries to reduce the myocardial contractility and maintain sufficient cardiac output by expanding the endocardial area.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the heart itself tries to reduce the myocardial contractility and maintain sufficient cardiac output by expanding the endocardial area. Eventually, normal myocardium transforms into a trabecular meshwork due to dysfunction of cardiomyocytes and gap junctions . Trabecularization of DCM is generally expressed on the LV lateral wall.…”

Section: Discussionmentioning

confidence: 99%

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Value of Cardiac Magnetic Resonance Fractal Analysis Combined With Myocardial Strain in Discriminating Isolated Left Ventricular Noncompaction and Dilated Cardiomyopathy

Zheng

et al. 2018

Magnetic Resonance Imaging

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Background Excessive trabeculation is present in isolated left ventricular noncompaction (LVNC) and dilated cardiomyopathy (DCM), which sometimes makes the differentiation between these two difficult. Fractal dimension (FD) is a unitless measure value of how completely the object fills space, which can assess the extent of myocardial trabeculae quantitatively. Purpose To compare the trabeculae features and myocardial strain derived from cardiac MR between LVNC and DCM. Study Type Respective case–control series. Population In all, 35 LVNC patients and 30 DCM patients were enrolled, and 20 healthy volunteers were selected as a control group. Field Strength/Sequence 5 T with 8‐channel phased‐array cardiac receiver coil including steady‐state free precession cine imaging. Assessment The degree of left ventricular trabeculation was evaluated by a semiautomatic tool based on fractal analysis. Myocardial deformation was assessed by feature tracking. Statistical Tests Independent samples Student's t‐test, Mann–Whitney U‐test, receiver operating characteristics (ROC) curves, and Spearman's rank coefficient were conducted. Results Max apical FD and mean global FD were higher in the LVNC group than in the DCM group (1.433 ± 0.074 vs. 1.341 ± 0.062, P < 0.001; 1.323 ± 0.036 vs. 1.267 ± 0.041, P < 0.001, respectively). For diagnosing LVNC, max apical FD was 1.392 (area under the curve [AUC] = 0.881, 95% confidence interval [CI]: 0.804–0.957), and the cutoff value of mean global FD was 1.283 (AUC = 0.895, 95% CI: 0.828–0.961). The global peak longitudinal strain value of the left ventricle (GPLS) showed significant differences between the LVNC group and DCM group [–6.49 (–11.41, –4.90) vs. –4.61 (–5.87, –3.61), P = 0.006]. The diagnostic accuracy for LVNC is highest when using FDs in coordination with GPLS (AUC = 0.93, 95% CI: 0.86–0.98, P < 0.001). Data Conclusion Fractal analysis provides a quantitative measurement of myocardial trabeculation. The combination of fractal analysis with myocardial strain provides a novel biomarker in distinguishing LVNC from DCM. Level of Evidence: 3 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:153–163.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Value of Cardiac Magnetic Resonance Fractal Analysis Combined With Myocardial Strain in Discriminating Isolated Left Ventricular Noncompaction and Dilated Cardiomyopathy

Zheng

et al. 2018

Magnetic Resonance Imaging

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“…Cardiac MRI (Figure 3) has better resolution compared to echocardiography, which makes it a preferred imaging modality in such patients. Cardiac MRI is also reliable in distinguishing LVNC from other causes of LV apical deformity, including apical variant of hypertrophic cardiomyopathy, endomyocardial fibrosis (EMF) and apical thrombus [42] . Pharmacological management of LVNC is mainly symptomatic and directed to relief of heart failure symptoms.…”

Section: Non-compactionmentioning

confidence: 99%

Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies

Sisakian¹

2014

WJC

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Cardiomyopathies are defined as diseases of the myocardium with associated structural and functional abnormalities. Knowledge of these pathologies for a long period was not clear in clinical practice due to uncertainties regarding definition, classification and clinical diagnosis. In recent decades, major advances have been made in the understanding of the molecular and genetic issues, pathophysiology, and clinical and radiological assessment of the diseases. Progress has been made also in management of several types of cardiomyopathy. Advances in the understanding of these diseases show that cardiomyopathies represent complex entities. Here, special attention is given to evolution of classification of cardiomyopathies, with the aim of assisting clinicians to look beyond schematic diagnostic labels in order to achieve more specific diagnosis. Knowledge of the genotype of cardiomyopathies has changed the pathophysiological understanding of their etiology and clinical course, and has become more important in clinical practice for diagnosis and prevention of cardiomyopathies. New approaches for clinical and prognostic assessment are provided based on contemporary molecular mechanisms of contribution in the pathogenesis of cardiomyopathies. The genotype-phenotype complex approach for assessment improves the clinical evaluation and management strategies of these pathologies. The review covers also the important role of imaging methods, particularly echocardiography, and cardiac magnetic resonance imaging in the evaluation of different types of cardiomyopathies. In summary, this review provides complex presentation of current state of cardiomyopathies from genetics to management aspects for cardiovascular specialists.

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“…[4][5][6] Recent studies have shown that fibrosis is an effective indicator of the severity and prognosis of LVNC. 7, 8 Therefore, early characterization of fibrosis in the myocardium of patients with LVNC prior to adverse outcomes is important for patient management.…”

mentioning

confidence: 99%

Characterization of Compacted Myocardial Abnormalities by Cardiac Magnetic Resonance With Native T1 Mapping in Left Ventricular Non-Compaction Patients　– A Comparison With Late Gadolinium Enhancement –

Zhou

Xue

Fang

et al. 2016

Circ J

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Background: Native T1 mapping is an emerging cardiac magnetic resonance technique for quantitative evaluation of cardiomyopathies. This study aimed to investigate the usefulness of native T1 mapping in characterizing myocardial abnormalities in left ventricular non-compaction (LVNC) by comparing it with late gadolinium enhancement (LGE). Methods and Results:The study group of 31 LVNC patients and 8 normal controls underwent cardiovascular magnetic resonance to acquire the native T1 maps and LGE images. Of the 31 LVNC patients, 14 had LGE. The mean native T1 value of the normal controls, LGE(−) and LGE(+) patients was 1,098.8±40.8 ms, 1140.6±32.8 ms, and 1181.4±53.7 ms, respectively. Significant differences were found in native T1 between any 2 groups (F=9.74, P<0.001). In discriminating the presence of LGE in LVNC patients, the odds ratio and corresponding 95% confidence interval (CI) of native T1 were, respectively, 2.966 (95% CI: 1.123-7.835, P=0.028) and 4.348 (95% CI: 1.155-16.363, P=0.030) before and after adjusting for confounding factors with an increment of 1 standard deviation. Conclusions:The finding that LGE(−) patients had elevated native T1 compared with normal controls suggested native T1 mapping can be used earlier than LGE imaging to detect myocardial fibrosis in LVNC patients. Furthermore, higher native T1 values in LGE(+) patients than in the LGE(−) group suggested native T1 mapping is more sensitive than LGE imaging for identifying myocardial fibrosis in LVNC patients. 1211 Native T1 Mapping Evaluates Myocardium Abnormality factors for cardiac disease (diabetes mellitus, hypertension, and smoking) were enrolled as normal controls. The age and sex of the normal volunteers were matched with the LVNC patient group. Clinical information was collected from the medical record. The study protocol was approved by the local Institutional review board and written informed consent was given by all subjects. CMR ProtocolThe CMR imaging was performed with a 3.0-T MR system (Achieva TX, Philips Healthcare, Best, The Netherlands) using a 32-channel phased array heart coil (InVivo, Gainesville, FL, USA). The cine, phase-sensitive inversion recovery (PSIR), and modified look-locker inversion recovery (MOLLI) image sequences were acquired. 16 The ECG-gated balanced steadystate free precession (bSSFP) cine images of the long-and short-axis (SAX) images covering the entire LV were acquired with the following parameters: TR/TE 2.7/1.3 ms with 30 heart phases; voxel size 1.8×1.5×8.0 mm 3 ; slice thickness 8 mm; and slice spacing 2 mm. The PSIR sequence was acquired 15±5 min after the injection of 0.2 mmol/kg of gadolinium-DTPA (Magnetism, Bayer Schering Pharma, Guangzhou, China) with flow rate of 3 ml/s and 20 ml saline for flushing. The LGE images were obtained during mid-diastole in the same SAX orientations as cine, covering the whole LV, with the following imaging

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Comparison of cardiac magnetic resonance imaging features of isolated left ventricular non-compaction in adults versus dilated cardiomyopathy in adults

Cited by 22 publications

References 32 publications

Value of Cardiac Magnetic Resonance Fractal Analysis Combined With Myocardial Strain in Discriminating Isolated Left Ventricular Noncompaction and Dilated Cardiomyopathy

Value of Cardiac Magnetic Resonance Fractal Analysis Combined With Myocardial Strain in Discriminating Isolated Left Ventricular Noncompaction and Dilated Cardiomyopathy

Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies

Characterization of Compacted Myocardial Abnormalities by Cardiac Magnetic Resonance With Native T1 Mapping in Left Ventricular Non-Compaction Patients　– A Comparison With Late Gadolinium Enhancement –

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Comparison of cardiac magnetic resonance imaging features of isolated left ventricular non-compaction in adults versus dilated cardiomyopathy in adults

Cited by 22 publications

References 32 publications

Value of Cardiac Magnetic Resonance Fractal Analysis Combined With Myocardial Strain in Discriminating Isolated Left Ventricular Noncompaction and Dilated Cardiomyopathy

Value of Cardiac Magnetic Resonance Fractal Analysis Combined With Myocardial Strain in Discriminating Isolated Left Ventricular Noncompaction and Dilated Cardiomyopathy

Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies

Characterization of Compacted Myocardial Abnormalities by Cardiac Magnetic Resonance With Native T1 Mapping in Left Ventricular Non-Compaction Patients – A Comparison With Late Gadolinium Enhancement –

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Characterization of Compacted Myocardial Abnormalities by Cardiac Magnetic Resonance With Native T1 Mapping in Left Ventricular Non-Compaction Patients　– A Comparison With Late Gadolinium Enhancement –