Author + information
- Received January 10, 2013
- Revision received January 16, 2013
- Accepted January 22, 2013
- Published online September 1, 2013.
- R. Brandon Stacey, MD, MS∗∗ (, )
- Mousumi M. Andersen, MD∗,
- Mitchell St. Clair, MD∗,
- W. Gregory Hundley, MD∗,† and
- Vinay Thohan, MD∗
- ∗Department of Internal Medicine, Section on Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- †Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- ↵∗Reprint requests and correspondence:
Dr. R. Brandon Stacey, Cardiology Section, Watlington Hall, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157-1045.
Objectives This study used cardiac magnetic resonance (CMR) to compare standard criteria for left ventricular noncompaction (LVNC).
Background LVNC as a distinct cardiomyopathy is supported by a growing number of publications. Echocardiographic and CMR criteria have been established to diagnosis LVNC but have led to concerns of diagnostic accuracy.
Methods Trabeculation/possible LVNC by CMR was retrospectively observed in 122 consecutive cases. We compared the standard end-systolic noncompacted-to-compacted ratio (ESNCCR), end-diastolic noncompacted:compacted ratio (EDNCCR), and trabecular mass-to-total mass ratio (TMTMR) along with deaths, embolic events, congestive heart failure (CHF) readmissions, ventricular arrhythmias, myocardial thickening (MT), left ventricular ejection fraction (LVEF), 3-dimensional sphericity index (3DSi), and left ventricular end-diastolic volume index. Adjusting for age, race, sex, body surface area, diabetes mellitus, hypertension, hyperlipidemia, coronary artery disease, and CHF, logistic regression was used to compare combined events (death, CHF readmission, embolism, ventricular arrhythmia) between ESNCCR, EDNCCR, and TMTMR. Adjusting for same covariates except CHF, logistic regression was used to compare the odds of CHF for those who met criteria and those who did not. Using analysis of covariance, adjusted means for LVEF, MT, 3DSi, and left ventricular end-diastolic volume index were generated.
Results ES criteria had a higher odds ratio (8.6; 95% confidence interval [CI]: 2.5 to 33) for combined events than ED criteria (1.8; 95% CI: 0.6 to 5.8) or TMTMR criteria (3.14; 95% CI: 1.09 to 10.2). The odds ratio of CHF for those who met ESNCCR criteria was 29.4 (95% CI: 6.6 to 125), but the odds ratio of CHF for those who met EDNCCR criteria was 3.3 (95% CI: 1.1 to 9.2). After adjustment, those who met criteria for noncompaction by ESNCCR had a lower LVEF and less MT than those who did not (p = 0.01 and p = 0.003, respectively), but there was no difference between those who met criteria for EDNCCR or the TMTMR criteria and those who did not.
Conclusions ES measures of LVNC have stronger associations with events, CHF, and systolic dysfunction than other measures.
All authors have reported that they have no relationships relevant to the contents of this paper to disclose. Eike Nagel, MD, PhD, served as Guest Editor for this article.
- Received January 10, 2013.
- Revision received January 16, 2013.
- Accepted January 22, 2013.
- American College of Cardiology Foundation