Usefulness of speckle myocardial imaging modalities for differential diagnosis of left ventricular non-compaction of the myocardium

Cortés, Marcelino; Oliva, María Reyes; Orejas, Miguel; Navas, Miguel Ángel Muñoz; Rábago, Rosa; Martínez, María Esther de Quesada; Taibo, Mikel; Palfy, Julia Anna; Rey, Manuel; Farré, Jerónimo

doi:10.1016/j.ijcard.2016.08.278

Cited by 18 publications

(24 citation statements)

References 37 publications

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“…Although there are multiple studies describing the strain characteristics of LVNC assessed by STE [15][16][17][18], CMR FT has some potential advantages that may provide a more accurate and reproducible assessment. The comparatively unrestricted access to multi-planar views and excellent contrast between the myocardium and blood pool allows reproducible imaging planes and clear boundary points for the measurement of myocardial strain [19].…”

Section: Discussionmentioning

confidence: 99%

“…In order to expand beyond pure morphologic features and global volumetric parameters of cardiac function in the diagnosis and assessment of ischemic and nonischemic cardiomyopathies, quantitative assessment of myocardial deformation by strain analysis has developed over recent years. Speckle-tracking echocardiography (STE) has demonstrated abnormal patterns of LV myocardial strain and torsion in LVNC including decreased radial, circumferential and longitudinal strain, decreased LV twist and abnormal patterns of ventricular rotation [15][16][17][18]. Strain analysis by CMR feature tracking (FT) using routine cine balanced steady-state free precession (bSSFP) data sets can reproducibly quantify myocardial deformation across multiple parameters [19].…”

Section: Introductionmentioning

confidence: 99%

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Cardiovascular magnetic resonance based diagnosis of left ventricular non-compaction cardiomyopathy: impact of cine bSSFP strain analysis

Dreisbach

Mathur

Houbois

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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Background: Investigation of the myocardial strain characteristics of the left ventricular non-compaction (LVNC) phenotype with cardiovascular magnetic resonance (CMR) feature tracking. Methods: CMR cine balanced steady-state free precession data sets of 59 retrospectively identified LVNC phenotype patients (40 years, IQR: 28-50 years; 51% male) and 36 healthy subjects (39 years, IQR: 30-47 years; 44% male) were evaluated for LV volumes, systolic function and mass. Hypertrabeculation in patients and healthy subjects was evaluated against established CMR diagnostic criteria. Global circumferential strain (GCS), global radial strain (GRS) and global longitudinal strain (GLS) were evaluated with feature-tracking software. Subgroup analyses were performed in patients (n = 25) and healthy subjects (n = 34) with normal LV volumetrics, and with healthy subjects (n = 18) meeting at least one LVNC diagnostic criteria. Results: All LVNC phenotype patients, as well as a significant proportion of healthy subjects, met morphology-based CMR diagnostic criteria: non-compacted (NC): compacted myocardial diameter ratio > 2.3 (100% vs. 19.4%), NC mass > 20% (100% vs. 44.4%) and > 25% (100% vs. 13.9%), and NC mass indexed to body surface area > 15 g/m 2 (100% vs. 41.7%). LVNC phenotype patients demonstrated reduced GRS (26.4% vs. 37.1%; p < 0.001), GCS (− 16.5% vs. -20.5%; p < 0.001) and GLS (− 14.6% vs. -17.1%; p < 0.001) compared to healthy subjects, with statistically significant differences persisting on subgroup comparisons of LVNC phenotype patients with healthy subjects meeting diagnostic criteria. GCS also demonstrated independent and incremental diagnostic value beyond each of the morphology-based CMR diagnostic criteria. Conclusions: LVNC phenotype patients demonstrate impaired strain by CMR feature tracking, also present on comparison of subjects with normal LV volumetrics meeting diagnostic criteria. The high proportion of healthy subjects meeting morphology-based CMR diagnostic criteria emphasizes the important potential complementary diagnostic value of strain in differentiating LVNC from physiologic hypertrabeculation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cardiovascular magnetic resonance based diagnosis of left ventricular non-compaction cardiomyopathy: impact of cine bSSFP strain analysis

Dreisbach

Mathur

Houbois

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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“…Myocardial strain is a quantitative parameter for evaluating myocardial function. Previous studies on myocardial strain had already demonstrated subclinical abnormalities even in LVNC patients with preserved ejection fraction . Cardiac MR myocardial strain analysis was based on feature tracking (FT), which is an established method for quantitative wall motion analysis by quantification of changes in signal intensity within voxels from one frame to the next .…”

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confidence: 99%

“…Previous studies on myocardial strain had already demonstrated subclinical abnormalities even in LVNC patients with preserved ejection fraction. [9][10][11] Cardiac MR myocardial strain analysis was based on feature tracking (FT), which is an established method for quantitative wall motion analysis by quantification of changes in signal intensity within voxels from one frame to the next. 12 The results were defined as strain and strain rate in the three cardiac planes (circumferential, radial, and longitudinal).…”

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confidence: 99%

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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“…However, given the lack of a universally accepted definition and consensus on most recommendable diagnostic criteria, the false positive rates are considerably high leading to overdiagnosis of LVNC in individuals with physiological trabeculations such as athletes, individuals of Afro-Caribbean origin, patients with sickle cell anemia, and pregnant women. Cortés et al [5] in their study involving speckle imaging demonstrated that presence of an anomalous rotation in which the base and apex of the left ventricle rotate in the same direction also known as rigid body rotation offers the potential for differentiation of LVNC from physiological states and other forms of cardiomyopathies. Thus with increasing awareness of this form of cardiomyopathy with increasing insight into genetics coupled with the use of genetic counseling, the use of a multidisciplinary approach is expected to improve the diagnosis and outcomes.…”

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confidence: 99%

Left ventricular noncompaction cardiomyopathy: Recent update on genetics, usefulness of biomarker, and speckle imaging

Akhtar

Bandyopadhyay

Ghosh

et al. 2019

Journal of Cardiology

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Left ventricular noncompaction cardiomyopathy (LVNC) is an emerging form of predominantly genetically mediated cardiomyopathy characterized by failure of intrauterine compaction of the myocardium leading to the formation of two distinct layers of myocardium, an outer compacted thinner epicardial layer and an inner hypertrophied non compacted endocardial layer interspersed by blood-filled intertrabecular recess.We read with great interest the review article by Ikeda et al.[1] titled [ 1 8 _ T D $ D I F F ]`Isolated left ventricular non-compaction cardiomyopathy in adults[ 1 9 _ T D $ D I F F ] '' giving a comprehensive overview of this emerging form of cardiomyopathy. LVNC is a relatively rare form of cardiomyopathy and listed under the category of genetic cardiomyopathies by the American Heart Association. With the improvement in diagnostic modalities the incidence of LVNC has increased in clinical practice, however, still there is lack of familiarity among clinicians about this form of cardiomyopathy. The pathogenesis of LVNC is characterized by a deviation from normal embryological development in which there is involution of trabeculations and formation of the compact myocardium in ventricles and transformation of the intertrabecular recess into capillaries with the development of coronary vessels by [ 2 0 _ T D $ D I F F ] 12-18 weeks of gestation. However, in LVNC, the embryological spongy appearance of myocardium persists after birth and results in the formation of two distinct layers of the myocardium. LVNC may occur in isolation or may be associated with other cardiac anomalies like Ebstein anomaly [2]. Clinical presentation of LVNC varies across the spectrum from a severe prenatal form of systolic heart failure to asymptomatic adults. Classically it is characterized by the triad of systolic heart failure, arrhythmia, and thromboembolic phenomena.In a recently published study, van Waning et al.[3] studied the correlation of genetics with clinical features and outcomes among children and adults diagnosed with LVNC. In most families, LVNC is characterized by the autosomal dominant pattern of inheritance with variable penetration. They showed that nearly one-third of LVNC patients had a mutation in cardiomyopathy gene. MYH7,

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Usefulness of speckle myocardial imaging modalities for differential diagnosis of left ventricular non-compaction of the myocardium

Cited by 18 publications

References 37 publications

Cardiovascular magnetic resonance based diagnosis of left ventricular non-compaction cardiomyopathy: impact of cine bSSFP strain analysis

Cardiovascular magnetic resonance based diagnosis of left ventricular non-compaction cardiomyopathy: impact of cine bSSFP strain analysis

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

Left ventricular noncompaction cardiomyopathy: Recent update on genetics, usefulness of biomarker, and speckle imaging

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