The pivotal role of cardiovascular imaging in the identification and risk stratification of non-compaction cardiomyopathy patients

Mavrogeni, Sophie; Markousis‐Mavrogenis, George; Vartela, Vasiliki; Manolopoulou, Dionysia; Abate, Elena; Hamadanchi, Ali; Rigopoulos, Angelos; Kolovou, Genovefa; Noutsias, Michel

doi:10.1007/s10741-019-09898-8

Cited by 12 publications

(12 citation statements)

References 61 publications

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“…ARVC in particular may be detected in endurance athletes with VRDs and a normal RV structure, as well as function-wise (30). Additionally, 50% of patients with non-compaction cardiomyopathy may not be identified using echocardiographic evaluation alone, instead requiring disease demonstration with CMR (31,32). In children with HCM, myocardial fibrosis identified using LGE was associated with adverse events (15) and diffuse ventricular fibrosis identified by T1-mapping predicted non-sustained VT and aborted SCD in adult HCM patients (33).…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular magnetic resonance clarifies arrhythmogenicity in asymptomatic young athletes with ventricular arrhythmias undergoing pre‑participation evaluation

et al. 2020

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Pre-participation sports examination (PPE) is a frequent reason for consultation. However, the exact role of cardiovascular magnetic resonance (CMR) in PPE remains undefined. The additive value of CMR in adolescent athletes with ventricular rhythm disturbances (VRDs) was investigated. We prospectively recruited and evaluated with CMR 50 consecutive, asymptomatic young athletes referred to our tertiary center after identification of VRDs on electrocardiogram (ECG) with otherwise normal standard PPE and echocardiography, and 20 age-and sex-matched healthy volunteer athletes who underwent the same evaluations. The primary outcome was case-control status and the secondary outcome was the discrimination between athletes with VRDs with and without non-sustained ventricular tachycardia (VT). CMR identified arrhythmogenic substrates in all athletes with VRDs. The predominant condition was myocarditis and arrhythmogenic right ventricular cardiomyopathy in patients with and without VT, respectively. Based on penalized regression analysis, late gadolinium enhancement (LGE), early gadolinium enhancement (EGE), extracellular volume fraction (ECV), and T2-mapping, best distinguished between case-control status. The aforementioned indices predicted case-control status independent of age and sex: EGE [Odds ratio (95% confidence interval): 6.89 (2.19-21.62) per 0.5-unit, P<0.001], LGE (perfect prediction), ECV [1.66 (1.25-2.22), P<0.001] and T2 mapping [1.40 (1.13-1.72), P=0.002], among other independent CMR-derived predictors. Only indexed ventricular volumes independently discriminated between VRD patients with and without VT. In this study, asymptomatic young athletes with VRDs and normal PPE/echocardiography were optimally discriminated from healthy control athletes by CMR-derived indices, and CMR allowed for the identification of arrhythmogenic substrates in all cases.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular magnetic resonance clarifies arrhythmogenicity in asymptomatic young athletes with ventricular arrhythmias undergoing pre‑participation evaluation

et al. 2020

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“…Transthoracic echocardiography remains the most common and initial diagnostic strategy, mainly due to its widespread availability, ease of interpretability, and low cost 3,36 . It allows a simple and reliable evaluation of ventricular size and function, wall thickness, and eventually associated CHD.…”

Section: Cardiac Imagingmentioning

confidence: 99%

“…As stated, the right ventricle may also be involved 4,26 , although no recognized criteria are available 3 . Contrast-enhanced TTE may be useful in cases of poor acoustic window and in differentiating NCCM from HCM 36 . Recently, advanced techniques (strain, strain rate, torsion) are being used 3,4 and the presence of base-apex longitudinal strain gradient may assist in differentiating between NCCM and DCM 38 .…”

Section: Cardiac Imagingmentioning

confidence: 99%

“…Given the higher quality and sensitivity in the detection of myocardial trabeculations, CMR has an important role in the confirmation of NCCM and also allows the identification/exclusion of thrombi and other coexisting abnormalities 4,36 . The same controversies remain regarding diagnostic criteria, however, the most used are those of Peterson et al 39 , consisting of a NC/C myocardium ratio >2.3 at end-diastole, and Jacquier et al 40 which requires a NC ventricular mass >20% of the global LV mass for diagnosis.…”

Section: Cardiac Imagingmentioning

confidence: 99%

“…The same controversies remain regarding diagnostic criteria, however, the most used are those of Peterson et al 39 , consisting of a NC/C myocardium ratio >2.3 at end-diastole, and Jacquier et al 40 which requires a NC ventricular mass >20% of the global LV mass for diagnosis. Aside from ventricular strain 36 , CMR also allows tissue characterization using late gadolinium enhancement (LGE) and T1-mapping to identify myocardial fibrosis, which could behave as a prognostic marker 4,30 . In a multicentre study by Andreini et al 41 , LGE (replacement fibrosis), LVSD and LV dilation were independently associated with cardiac events, while the degree of trabeculation was not.…”

Section: Cardiac Imagingmentioning

confidence: 99%

See 2 more Smart Citations

Understanding Noncompaction Cardiomyopathy: A Brief Comprehensive Review of A Controversial Entity

Santos¹,

Carvalho²,

Fernandes³

et al. 2020

J Cardiol and Cardiovasc Sciences

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Noncompaction cardiomyopathy is a heterogeneous and complex entity characterized by hypertrabeculation, typically of the left ventricle. Uncertainties regarding pathogenesis, classification as primary genetic or unclassified cardiomyopathy, diagnostic criteria, and risk stratification have contributed to fuel the discussion surrounding this disorder. Meanwhile, noncompaction phenotype is thought to be the morphological expression of different underlying pathophysiological mechanisms, genetics, and pathologies. Recent studies suggest that distinguishing genetic from nongenetic causes allows risk stratification and may support clinical management and counselling of patients and their relatives. Additionally, advanced cardiac imaging techniques have demonstrated a complementary role in outcome prediction. The purpose of this review is to provide a brief comprehensive review of this controversial entity.

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Ventricular non-compaction review

Srivastava

Yavari²,

Al-abcha³

et al. 2021

Heart Fail Rev

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The pivotal role of cardiovascular imaging in the identification and risk stratification of non-compaction cardiomyopathy patients

Cited by 12 publications

References 61 publications

Cardiovascular magnetic resonance clarifies arrhythmogenicity in asymptomatic young athletes with ventricular arrhythmias undergoing pre‑participation evaluation

Cardiovascular magnetic resonance clarifies arrhythmogenicity in asymptomatic young athletes with ventricular arrhythmias undergoing pre‑participation evaluation

Understanding Noncompaction Cardiomyopathy: A Brief Comprehensive Review of A Controversial Entity

Ventricular non-compaction review

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