Myocardial deformation pattern in left ventricular non-compaction: Comparison with dilated cardiomyopathy

Abstract

IntroductionLeft ventricular (LV) systolic dysfunction is the most frequent initial presentation of patient with LV noncompaction (NC). Our objectives were to evaluate myocardial contraction properties in patients with LVNC and the relationship of non-compacted segments with the degree of global and regional systolic deformation.MethodsWe included 50 LVNC with an echocardiography and speckle imaging calculation of peak longitudinal strain (PLS). Each of the 16 LV myocardial segments was defined as NC (ratio NC/compacted layer > 2), borderline (NC/C 0–2) and compacted (NC/C = 0). Basal, median and apical strain values were calculated as the average of segmental strain values. For comparison a group of 50 patients with dilated cardiomyopathy (DCM) underwent the same measurements.ResultsThere was no statistical difference between the 2 groups for any conventional LV systolic parameters. A characteristic deformation pattern was observed in LVNC with higher strain values in the LV apical segments (− 12.8 ± 5.9 vs − 10.7 ± 5.7) and an apical–basal ratio (1.52 ± 0.73 vs 1.12 ± 0.42; p < 0.001). There was no correlation between LV function and the degree of NC. Among 726 segments, compacta thickness was thinner in NC vs C segments (6.4 ± 1.4 vs 7.7 ± 1.8 mm; p < 0.05). There was no difference in WMS but regional strain values were significantly higher in NC compared to C segments (− 13.1 ± 6.1 vs − 10.2 ± 6.3; p < 0.05).ConclusionsCompared to DCM, LVNC presented with relatively preserved apical deformation as compared to basal segments. Lower regional deformation values in compacted segments confirm the concept that LVNC is a phenotypic marker of an underlying diffuse cardiomyopathy involving both C and NC myocardium.

Changes in strain parameters at different deterioration levels of left ventricular function: A cardiac magnetic resonance feature-tracking study of patients with left ventricular noncompaction

“…These results together with the evenly decreased circumferential segmental strain values suggest that the regional strain patterns in LVNC are very similar to those described in DCM and not specific to noncompaction as an etiological factor of heart failure. However, opposing results regarding the apical strain in LVNC can be found in the literature, which might be due to the different strain measurement techniques and the different vendors [8]. Furthermore, the lack of an LVNC-specific pattern might be due to the small sample size in our study, and the existence of LVNC-specific signs and patterns cannot be excluded.…”

“…A large number of speckle-tracking echocardiography studies were conducted with the aim of describing the myocardial deformation pattern of patients with LVNC and developing new and additional diagnostic criteria [7][8][9]. Nonetheless, the results are controversial.…”

Role of deformation imaging in left ventricular non-compaction and hypertrophic cardiomyopathy: an Indian perspective

“…Regional deformation analysis showed presence of apico-basal gradient in longitudinal strain among LVNC, which was not evident among HCM subgroups. Various studies focusing on these populations have shown wide range of results [6,9,10]. In contrast to our findings, study by Haland et al showed that LVNC exhibits homogenous reduction in longitudinal strain across basal and apical LV regions with no apico-basal gradient.…”

Noncompaction Cardiomyopathy—History and Current Knowledge for Clinical Practice

“…The measurements could discriminate between a normal counterclockwise pattern with reduced apical rotation peak values in LVHT and NCCM with rigid body rotation presenting with a sensitivity of 82% and a specificity of 92% [ 74 ]. In contrast, Huttin et al showed that myocardial deformation was preserved in the apical region [ 80 ].…”