Evaluation of Subtle Myocardial Noncompaction by Contrast Echocardiography in Patients With Hypertrophic Cardiomyopathy and Its Relationship With Regional Ventricular Systolic Dysfunction

Abstract

Methods-Speckle-tracking imaging and contrast echocardiography were performed in 40 patients with hypertrophic cardiomyopathy. Subtle noncompaction of the left ventricle was defined as myocardium with more than 3 trabeculations in a single imaging plane with a noncompaction to compaction ratio of greater than 0.4 and less than 2.0.Results-Among 647 segments, noncompaction was present in 46 segments (7%) in the left ventricular apex in 18 patients (45%) on the standard 2-dimensional echocardiograms and in 181 segments (27%) in 32 patients (80%) on the contrast-enhanced images. The mean number of segments affected by noncompaction ± SD was 6 ± 2. The mean noncompacted thickness was 5.6 ± 0.2 mm, and the ratio of the noncompacted to compacted layers was 1.1 ± 0.4 on the contrast-enhanced images. The global peak systolic longitudinal strain in patients with hypertrophic cardiomyopathy with noncompaction (-12.8% ± 2.8%) had a significantly lower absolute value than that in patients with hypertrophic cardiomyopathy without noncompaction (-17.4% ± 1.5%; P < .05) and healthy control participants (-20.6% ± 1.3%; P < .05). The number of segments with noncompaction and the interventricular septal thickness were both independent predictors of the global peak systolic longitudinal strain.Conclusions-Contrast echocardiography is superior to standard 2-dimensional echocardiography for detecting subtle noncompaction in patients with hypertrophic cardiomyopathy. We found that the global peak systolic longitudinal strain in patients with hypertrophic cardiomyopathy with noncompaction had a significantly lower absolute value than that in patients without noncompaction and healthy controls, indicating that the total number of segments affected by coexistent subtle noncompaction in patients with hypertrophic cardiomyopathy was an independent predictor of left ventricular systolic dysfunction.

Assessment of left ventricular twist mechanics by speckle tracking echocardiography reveals association between LV twist and myocardial fibrosis in patients with hypertrophic cardiomyopathy

“…The LV endocardial border was manually traced at the end-systolic frame and the speckle tracking region of interest was automatically selected. The width of the region of interest was adjusted as necessary to accommodate the total thickness of the LV wall [ 17 ]. The computer automatically tracked stable objects in each frame using the sum of absolute differences algorithm.…”

Noncompaction cardiomyopathy: The role of advanced multimodality imaging techniques in diagnosis and assessment

“…The role of contrast echocardiography has been highlighted by multiple studies in the literature . There are many elements in the echocardiographic diagnosis of NCCM that are improved with the use of contrast echocardiography.…”

Non-Compact Cardiomyopathy or Ventricular Non-Compact Syndrome?

“…The global peak systolic longitudinal strain in patients with HCM with non-compaction has been reported a significantly lower absolute value than that in patients without non-compaction and healthy controls, indicating that the total number of segments affected by coexistent subtle non-compaction in patients with HCM was an independent predictor of LV systolic dysfunction. 24) …”