Echocardiographic quantification of regional deformation helps to distinguish isolated left ventricular non-compaction from dilated cardiomyopathy

Aims Pronounced trabeculation is presented in both left ventricular non-compaction (LVNC) and dilated cardiomyopathy (DCM), which sometimes makes the differentiation difficult. We hypothesized that echocardiographic deformation analysis would help to differentiate these two cardiomyopathies. Methods...

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Bibliographic Details
Published in:European journal of heart failure 2012-02, Vol.14 (2), p.155-161
Main Authors: Niemann, Markus, Liu, Dan, Hu, Kai, Cikes, Maja, Beer, Meinrad, Herrmann, Sebastian, Gaudron, Philipp Daniel, Hillenbrand, Hanns, Voelker, Wolfram, Ertl, Georg, Weidemann, Frank
Format: Article
Language:English
Subjects:
Adult
Aged
Cardiomyopathy, Dilated - diagnostic imaging
Deformation imaging
Dilated cardiomyopathy
Echocardiography
Female
Heart Ventricles - diagnostic imaging
Humans
Isolated Noncompaction of the Ventricular Myocardium - diagnostic imaging
Left ventricular non-compaction
Male
Middle Aged
Tissue Doppler
Young Adult
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Summary:Aims Pronounced trabeculation is presented in both left ventricular non-compaction (LVNC) and dilated cardiomyopathy (DCM), which sometimes makes the differentiation difficult. We hypothesized that echocardiographic deformation analysis would help to differentiate these two cardiomyopathies. Methods and results We investigated 15 patients with LVNC (9 males; 42 ± 9 years), 15 age- and gender-matched DCM patients, and 15 healthy controls. The echocardiographic diagnosis of LVNC was confirmed by magnetic resonance imaging. In all subjects standard echocardiography and tissue Doppler imaging (TDI) to study regional LV deformation were carried out. No statistical difference was observed in standard echocardiographic parameters between LVNC and DCM patients. Compared with controls, both patient groups showed significantly reduced annular displacements (septal: controls 14 ± 2 mm vs. DCM 6 ± 3 mm vs. LVNC 7 ± 3 mm) and reduced strain values of the LV segments. A characteristic deformation pattern with significantly higher values in the LV base compared with the apex was observed in patients with LVNC by deformation measurements with TDI. This gradient was found particularly in the lateral and inferior wall but spared the anteroseptal wall; non-compaction was not found in basal segments throughout the ventricle and also spared the anteroseptal midventricular wall. In DCM the strain and strain rate values were homogeneously reduced in all LV segments. Conclusion A special regional deformation pattern (preserved deformation in basal segments of LVNC) seems to be of major diagnostic help for the definite differential diagnosis of LVNC and DCM.
ISSN:1388-9842
1879-0844
DOI:10.1093/eurjhf/hfr164