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Okan T, Lodeen H, Abawkaw M, Stetsiv T, Semeniv V. Left Ventricular Noncompaction Cardiomyopathy in an Elderly Patient: A Case Report and Literature Review. Cureus 2023; 15:e38305. [PMID: 37261174 PMCID: PMC10226827 DOI: 10.7759/cureus.38305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/29/2023] [Indexed: 06/02/2023] Open
Abstract
Isolated left ventricular noncompaction cardiomyopathy (LVNC), also known as spongy myocardium, is an extremely rare congenital disorder belonging to unclassified cardiomyopathies by the World Health Organization and classified as a genetic cardiomyopathy by the American Heart Association. Adult prevalence is 0.017-0.26% in observational echocardiographic studies. The disease occurs due to the intrauterine arrest of normal myocardial compaction, leading to left ventricular dysfunction. Reported mortality is high, ranging from 35 to 47% over a 42- to 72-month follow-up period. Knowledge regarding proper diagnosis, morbidity, and prognosis is limited; thus, this disease is subdiagnosed. Our aim is to highlight a diagnostic approach to LVNC in an elderly patient and to stress specific diagnostic signs that make the disease more recognizable. We are reporting a case of noncompaction cardiomyopathy in a 62-year-old male without any significant past medical history who was referred to our clinic for arrhythmia evaluation. The patient had several brief episodes of palpitations over the past two months. On physical examination, he presented a blowing systolic murmur at the apex and an irregularly irregular rhythm. The 12-lead electrocardiogram (ECG) demonstrated atrial fibrillation and ST-T segment depression in the V4-V6 leads. A transthoracic echocardiogram (TTE) showed signs of dilated cardiomyopathy, severe eccentric left ventricular hypertrophy, decreased contractility with an ejection fraction (EF) <30%, moderate mitral and tricuspid regurgitations, and moderate pulmonary hypertension. Multiple prominent trabeculations were noticed in the middle and apical segments of the left ventricle. The noncompacted to compacted myocardium ratio was >2.5:1. Cardiac catheterization excluded ischemic heart disease. Cardiac magnetic resonance (CMR) imaging confirmed the diagnosis of LVNC. The patient started treatment with carvedilol, ramipril, verospiron, torasemide, and rivaroxaban. An implantable cardioverter-defibrillator (ICD) was recommended. In conclusion, the diagnosis of LVNC in the adult population is often delayed because of similarities with more frequently diagnosed diseases. TTE is the initial diagnostic test of choice. Additional imaging modalities (contrast echocardiography, CMR) can help confirm the diagnosis. Early diagnosis is crucial because of the high incidence of life-threatening complications related to heart failure, thromboembolic events, and ventricular arrhythmias. Additional prospective studies are needed to improve the management and outcomes of this rare cardiomyopathy.
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Affiliation(s)
- Tetyana Okan
- Department of Internal Medicine, Lviv National Medical University, Lviv, UKR
| | - Homayoon Lodeen
- Department of Internal Medicine, Jamaica Hospital Medical Center, New York, USA
| | - Michael Abawkaw
- Department of Internal Medicine, Jamaica Hospital Medical Center, New York, USA
| | - Taras Stetsiv
- Department of Radiology, St. Paraskeva Medical Center, Lviv, UKR
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Stöllberger C, Finsterer J. Correlation between pathoanatomic findings, imaging modalities, and genetic findings in patients with left ventricular hypertrabeculation/noncompaction. Expert Rev Cardiovasc Ther 2021; 19:595-606. [PMID: 34053374 DOI: 10.1080/14779072.2021.1937128] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Left ventricular hypertrabeculation, also named 'noncompaction' (LVHT) is a cardiac abnormality which is detected by pathoanatomic investigation or during cardiac surgery. Imaging techniques visualize LVHT by ventriculography, echocardiography, cardiac magnetic resonance imaging (CMRI) and computed tomography (CT).Areas covered: We aimed to assess 1) how often the definition of LVHT was validated against a criterion standard, 2) if inter- and intra-observer agreement was assessed, and 3) how often LVHT was associated with genetic diseases. A literature search disclosed 58 cases whose hearts were investigated pathoanatomically and by ≥1 imaging technique. Echocardiography was most frequently (95%) compared with pathoanatomy, followed by cMRI (31%), ventriculography (7%) and CT (5%). Intra- and inter-observer agreement was more frequently assessed for cMRI definitions and yielded more consistent results than for echocardiographic definitions. Since genetic findings were only reported from 4 of the 58 cases, no association with imaging findings could be carried out.Expert opinion: Correlation between pathoanatomic investigations with imaging techniques will hopefully contribute to reliable and uniformly accepted definitions of LVHT. Most probably, the echocardiographic definition of LVHT will be a synthesis of the currently used definitions, integrating short axis and four-chamber views. A refinement of cMRI definitions, considering pathoanatomic and echocardiographic investigations, seems necessary to avoid overdiagnosis.
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Gerecke BJ, Engberding R. Noncompaction Cardiomyopathy-History and Current Knowledge for Clinical Practice. J Clin Med 2021; 10:2457. [PMID: 34206037 PMCID: PMC8199228 DOI: 10.3390/jcm10112457] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/24/2021] [Accepted: 05/27/2021] [Indexed: 01/10/2023] Open
Abstract
Noncompaction cardiomyopathy (NCCM) has gained increasing attention over the past twenty years, but in daily clinical practice NCCM is still rarely considered. So far, there are no generally accepted diagnostic criteria and some groups even refuse to acknowledge it as a distinct cardiomyopathy, and grade it as a variant of dilated cardiomyopathy or a morphological trait of different conditions. A wide range of morphological variants have been observed even in healthy persons, suggesting that pathologic remodeling and physiologic adaptation have to be differentiated in cases where this spongy myocardial pattern is encountered. Recent studies have uncovered numerous new pathogenetic and pathophysiologic aspects of this elusive cardiomyopathy, but a current summary and evaluation of clinical patient management are still lacking, especially to avoid mis- and overdiagnosis. Addressing this issue, this article provides an up to date overview of the current knowledge in classification, pathogenesis, pathophysiology, epidemiology, clinical manifestations and diagnostic evaluation, including genetic testing, treatment and prognosis of NCCM.
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Affiliation(s)
- Birgit J. Gerecke
- Department of Cardiology and Pneumology, University Medical Center Göttingen, 37075 Göttingen, Germany
- Department of Thoracic and Cardiovascular Surgery, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Rolf Engberding
- Internal Medicine & Cardiology, amO MVZ, Academic Hospital Wolfsburg, 38440 Wolfsburg, Germany;
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Anwer S, Heiniger PS, Rogler S, Erhart L, Cassani D, Kuzo N, Rebellius L, Schoenenberger-Berzins R, Schmid D, Nussbaum S, Schindler M, Kebernik J, Pazhenkottil AP, Gotschy A, Manka R, Meyer M, Gruner C, Tanner FC. Left ventricular mechanics and cardiovascular outcomes in non-compaction phenotype. Int J Cardiol 2021; 336:73-80. [PMID: 33964317 DOI: 10.1016/j.ijcard.2021.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/03/2021] [Indexed: 12/24/2022]
Abstract
AIMS This study aims at understanding left ventricular (LV) mechanics of non-compaction (LVNC) phenotype using echocardiographic strain analysis and at assessing the association of functional parameters with cardiovascular (CV) outcomes. METHODS AND RESULTS Longitudinal (GLS) and circumferential strain (GCS) as well as rotation of the LV were analyzed in 55 LVNC patients and 55 matched controls. Cardiovascular outcomes were documented for a median follow-up duration of 6 years. GLS and GCS were impaired in LVNC. Similary, regional longitudinal and circumferential strain as well as twist were reduced. CV events occurred in 28 LVNC patients. Apical peak circumferential strain (APCS), peak systolic rotation of apical segments (APSR), and twist were strongly associated with events. This was independent of and incremental to LVEF and non-compacted to compacted myocardial thickness ratio (NC:C ratio). The association of twist with events was also independent of and slightly superior to GLS. CONCLUSIONS GLS, GCS, regional strain, and twist were impaired in LVNC. APCS, APSR, and twist exhibited strong association with CV events independent of and incremental to LVEF and NC:C ratio, and in case of twist even GLS. Thus, STE-derived parameters may complement the echocardiographic assessment of LVNC patients in clinical routine.
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Affiliation(s)
- Shehab Anwer
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Pascal S Heiniger
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Sebastian Rogler
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Ladina Erhart
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Daniela Cassani
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Nazar Kuzo
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Lina Rebellius
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | | | - Dominik Schmid
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Sinuhe Nussbaum
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Matthias Schindler
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Julia Kebernik
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Aju Paul Pazhenkottil
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Alexander Gotschy
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Robert Manka
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Martin Meyer
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Christiane Gruner
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland
| | - Felix C Tanner
- Department of Cardiology, University Heart Center, University Hospital Zürich, Zurich, Switzerland.
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Filho DCS, do Rêgo Aquino PL, de Souza Silva G, Fabro CB. Left Ventricular Noncompaction: New Insights into a Poorly Understood Disease. Curr Cardiol Rev 2021; 17:209-216. [PMID: 32674738 PMCID: PMC8226207 DOI: 10.2174/1573403x16666200716151015] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/20/2020] [Accepted: 06/03/2020] [Indexed: 11/22/2022] Open
Abstract
Left ventricular noncompaction (LVNC) is a congenital pathology that directly affects the lining walls of myocardial tissue, causing trabeculations with blood filling in the inner wall of the heart, concomitantly with the development of a mesocardial thinning. Although LVNC was described for the first time as long ago as 1984, our understanding of the disease with regard to its genetic pattern, diagnosis, clinical presentation and treatment is still scanty. LVNC can present as an isolated condition or associated with congenital heart disease, genetic syndromes or neuromuscular disease. This suggests that LVNC is not a distinct form of cardiomyopathy, but rather a morphological expression of different diseases. Recognition of the disease is of fundamental importance because its clinical manifestations are variable, ranging from the absence of any symptom to congestive heart failure, lethal arrhythmias and thromboembolic events. The study of this disease has emphasized its genetic aspects, as it may be of sporadic origin or hereditary, in which case it most commonly has an autosomal dominant inheritance or one linked to the X chromosome. Echocardiography is the gold standard for diagnosis, and magnetic resonance imaging may refine the identification of the disease, especially in those patients with non-conclusive echocardiography. This article sets out to review the main characteristics of LVNC and present updates, especially in the genetic pattern, diagnosis and treatment of the disease.
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Affiliation(s)
- Dário C. Sobral Filho
- Address correspondence to this author at the R. dos Palmares - Santo Amaro, 252, Recife - PE, zipcode: 50.100-060, Brazil; E-mail:
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Mannoubi S, Mesrati MA, Hassen IHA, Hasnaoui T, Limem H, Boussaid M, Ben Abdejlil N, Aissaoui A. Case Report: Sudden cardiac death due to ventricular myocardial non-compaction. F1000Res 2020; 9:1045. [PMID: 34471520 PMCID: PMC8329599 DOI: 10.12688/f1000research.24583.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 11/21/2022] Open
Abstract
Ventricular non-compaction (VNC) is a rare myocardium disorder, which can be both genetic and sporadic. A poor wall compaction process or an excessive trabeculae formation may be at the genesis of myocardial hypertrabeculation with multiple recesses. It is often complicated by ventricular dysfunction, arrhythmias and cardiac embolism. Herein we report a case of a 20-year-old male patient with no particular past medical history who was followed up at the cardiology department for dyspnea. Echocardiography showed reduced ejection fraction of the left ventricle with potential hypertrabeculation in the right ventricle, confirmed by cardiac MRI. The patient was not put under medication and was later lost to follow-up. He died few months later without a clear cause explaining death. A forensic autopsy was performed that attributed death to acute ventricle arrhythmia secondary to VNC, emphasizing the major role of an early and specific treatment to avoid such a fatal outcome.
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Affiliation(s)
- Syrine Mannoubi
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Med Amin Mesrati
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Ibn Hadj Amor Hassen
- Department of Cardiology, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Taha Hasnaoui
- Department of Cardiology, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Hiba Limem
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Marwa Boussaid
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Nouha Ben Abdejlil
- Department of Pathology, Fattouma Bourguiba Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Abir Aissaoui
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
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Mannoubi S, Mesrati MA, Hassen IHA, Hasnaoui T, Limem H, Boussaid M, Ben Abdejlil N, Aissaoui A. Case Report: Sudden cardiac death due to ventricular myocardial non-compaction. F1000Res 2020; 9:1045. [PMID: 34471520 PMCID: PMC8329599 DOI: 10.12688/f1000research.24583.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2020] [Indexed: 08/14/2024] Open
Abstract
Ventricular non-compaction (VNC) is a rare myocardium disorder, which can be both genetic and sporadic. A poor wall compaction process or an excessive trabeculae formation may be at the genesis of myocardial hypertrabeculation with multiple recesses. It is often complicated by ventricular dysfunction, arrhythmias and cardiac embolism. Herein we report a case of a 20-year-old male patient with no particular past medical history who was followed up at the cardiology department for dyspnea. Echocardiography showed reduced ejection fraction of the left ventricle with potential hypertrabeculation in the right ventricle, confirmed by cardiac MRI. The patient was not put under medication and was later lost to follow-up. He died few months later without a clear cause explaining death. A forensic autopsy was performed that attributed death to acute ventricle arrhythmia secondary to VNC, emphasizing the major role of an early and specific treatment to avoid such a fatal outcome.
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Affiliation(s)
- Syrine Mannoubi
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Med Amin Mesrati
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Ibn Hadj Amor Hassen
- Department of Cardiology, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Taha Hasnaoui
- Department of Cardiology, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Hiba Limem
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Marwa Boussaid
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Nouha Ben Abdejlil
- Department of Pathology, Fattouma Bourguiba Hospital, University of Monastir, Mahdia, 5100, Tunisia
| | - Abir Aissaoui
- Department of Forensic Medicine, Taher Sfar Hospital, University of Monastir, Mahdia, 5100, Tunisia
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8
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Masso AH, Uribe C, Willerson JT, Cheong BY, Davis BR. Left Ventricular Noncompaction Detected by Cardiac Magnetic Resonance Screening: A Reexamination of Diagnostic Criteria. Tex Heart Inst J 2020; 47:183-193. [PMID: 32997774 DOI: 10.14503/thij-19-7157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
In a previous cross-sectional screening study of 5,169 middle and high school students (mean age, 13.1 ± 1.78 yr) in which we estimated the prevalence of high-risk cardiovascular conditions associated with sudden cardiac death, we incidentally detected by cardiac magnetic resonance (CMR) 959 cases (18.6%) of left ventricular noncompaction (LVNC) that met the Petersen diagnostic criterion (noncompaction:compaction ratio >2.3). Short-axis CMR images were available for 511 of these cases (the Short-Axis Study Set). To determine how many of those cases were truly abnormal, we analyzed the short-axis images in terms of LV structural and functional variables and applied 3 published diagnostic criteria besides the Petersen criterion to our findings. The estimated prevalences were 17.5% based on trabeculated LV mass (Jacquier criterion), 7.4% based on trabeculated LV volume (Choi criterion), and 1.3% based on trabeculated LV mass and distribution (Grothoff criterion). Absent longitudinal clinical outcomes data or accepted diagnostic standards, our analysis of the screening data from the Short-Axis Study Set did not definitively differentiate normal from pathologic cases. However, it does suggest that many of the cases might be normal anatomic variants. It also suggests that cases marked by pathologically excessive LV trabeculation, even if asymptomatic, might involve unsustainable physiologic disadvantages that increase the risk of LV dysfunction, pathologic remodeling, arrhythmias, or mural thrombi. These disadvantages may escape detection, particularly in children developing from prepubescence through adolescence. Longitudinal follow-up of suspected LVNC cases to ascertain their natural history and clinical outcome is warranted.
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Affiliation(s)
- Anthony H Masso
- Department of Cardiology, The University of Texas School of Public Health, Houston, Texas 77030
| | - Carlo Uribe
- Department of Cardiology, The University of Texas School of Public Health, Houston, Texas 77030
| | - James T Willerson
- Department of Cardiology, The University of Texas School of Public Health, Houston, Texas 77030
| | - Benjamin Y Cheong
- Department of Cardiology, The University of Texas School of Public Health, Houston, Texas 77030.,Department of Cardiovascular Radiology, Texas Heart Institute, The University of Texas School of Public Health, Houston, Texas 77030
| | - Barry R Davis
- Department of Biostatistics, The University of Texas School of Public Health, Houston, Texas 77030
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Negri F, De Luca A, Fabris E, Korcova R, Cernetti C, Grigoratos C, Aquaro GD, Nucifora G, Camici PG, Sinagra G. Left ventricular noncompaction, morphological, and clinical features for an integrated diagnosis. Heart Fail Rev 2020; 24:315-323. [PMID: 30612215 DOI: 10.1007/s10741-018-9763-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The presence of myocardial noncompaction (NC), regardless of the criterion used, does not identify cardiomyopathy per se. The distinction between a morphological variant and the presence of an NC cardiomyopathy is challenging. However, thanks to larger cohorts of patients and longer periods of follow-up, better clinical characterization and prognostic evaluation are becoming available. Indeed, the physician is required to integrate the evidence of NC with the clinical history of the patient, which is supplemented by necessary advanced instrumental investigations before a definite diagnosis of NC cardiomyopathy can be made. Therefore, we extensively revised the current literature in order to help the clinicians to identify clinical features which are pivotal supporting diagnostic element for the correct recognition of Left ventricular noncompaction cardiomyopathy and thus highlighting the difference between a form of cardiomyopathy and a mere intraventricular hypertrabeculation.
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Affiliation(s)
- Francesco Negri
- Cardiovascular Department, Cardiomyopathy Center, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy.
| | - Antonio De Luca
- Cardiovascular Department, Cardiomyopathy Center, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Enrico Fabris
- Cardiovascular Department, Cardiomyopathy Center, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Renata Korcova
- Cardiovascular Department, Cardiomyopathy Center, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Carlo Cernetti
- Head of Cardio-Neuro-Vascular Department Ca' Foncello and San Giacomo Hospital Azienda N 2, Marca Trevigiana, Treviso, Italy
| | - Chrysanthos Grigoratos
- Fondazione G. Monastiero CNR-Regione Toscana, Pisa, Italy.,Scuola Superiore Sant'Anna, Institute of Life Sciences, Pisa, Italy
| | | | - Gaetano Nucifora
- Northwest Heart Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.,Flinders University, Bedford Park, Adelaide, Australia
| | - Paolo G Camici
- Vita-Salute University and San Raffaele Hospital, Milan, Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, Cardiomyopathy Center, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
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Streltsova AA, Gudkova AY, Kostareva AA. [Left ventricular non - compaction: contemporary view of genetic background, clinical course, diagnostic and treatment]. TERAPEVT ARKH 2019; 91:90-97. [PMID: 32598595 DOI: 10.26442/00403660.2019.12.000142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Indexed: 01/10/2023]
Abstract
This review highlights and discusses recent advances in understanding left ventricular non - compaction (LVNC). Clinical profile, prognosis and even diagnosis are still a great challenge faced by the world. The population prevalence of left ventricular non - compaction remains unknown. High variability of clinical manifestations, genetic heterogenity with overlap of different phenotypes, variability of hereditary patterns suggests that LVNC seems to be rather an isolated trait or a part of phenotypic expression of different cardiac diseases or complex genetic syndromes.
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Affiliation(s)
| | - A Y Gudkova
- Almazov Federal Medical Research Centre.,Pavlov First St. Petersburg State Medical University
| | - A A Kostareva
- Almazov Federal Medical Research Centre.,Pavlov First St. Petersburg State Medical University
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Bardhi E, Faralli I, Deroma M, Galoppi P, Ventriglia F, Giancotti A, Perrone G, Brunelli R. Non-compaction cardiomyopathy in pregnancy: a case report of spongy myocardium in both mother and foetus and systematic review of literature. J Matern Fetal Neonatal Med 2019; 34:2910-2917. [PMID: 31570025 DOI: 10.1080/14767058.2019.1671337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Cardiovascular disease is the main nonobstetric cause of maternal death during pregnancy and is present in 0.5-4% of pregnancies in the western world. While hypertensive disorders remain the most frequent events, occurring in 6-8% of all pregnancies, cardiomyopathies are rare but encompass high complication rates. The aim of this systematic review is to report all data available up to date regarding pregnancies in patients with left ventricular noncompaction (LVNC) cardiomyopathy. METHODS PubMed, Medline, Cochrane, Scopus and Embase were searched, up to January 2019, using combinations of these terms: left ventricular noncompaction, hypertrabeculation cardiomyopathy, spongy myocardium, spongiform cardiomyopathy and delivery, gestation, pregnancy, cesarean section (CS). After careful selection, 22 articles, reporting a total of 30 cases, including our own were included in the review. RESULTS Fifteen out of 26 women (58%) were diagnosed with LVNC before pregnancy. Around 56% of women presented with symptoms during pregnancy while 44% were asymptomatic. Heart failure is by far the most common symptom occurring in almost half the cases. Uncommon clinical presentations included a heart attack, a stroke, and pulmonary hypertension. Timing of delivery was reported preterm in 58% of cases and at term in 42%. Eleven women gave birth through vaginal delivery, while 15 (58%) underwent a CS. Our reported case is the first case of a pregnancy where both mother and fetus are affected by LVNC and the fetus is diagnosed prenatally. CONCLUSIONS LVNC is not a contraindication for pregnancy, but clearly increases the risk of preterm birth and the rate of cesarean section. On the other hand, pregnancy in a LVNC patient exposes her to increased risk of clinical deterioration. Further studies are needed to better characterize the management of pregnancies in women with cardiomyopathies.
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Affiliation(s)
- Erlisa Bardhi
- Umberto I Policlinico di Roma, Maternal and Child Health and Urological Sciences, Rome, Italy
| | - Ida Faralli
- Umberto I Policlinico di Roma, Maternal and Child Health and Urological Sciences, Rome, Italy
| | - Marianna Deroma
- Umberto I Policlinico di Roma, Maternal and Child Health and Urological Sciences, Rome, Italy
| | - Paola Galoppi
- Department of Gynecologic, Obstetric and Urologic Sciences, Sapienza - University, Rome, Italy
| | - Flavia Ventriglia
- Department of Obstetrics and Gynecology, Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Antonella Giancotti
- Department of Obstetrics and Gynecology, Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Giuseppina Perrone
- Department of Gynecologic, Obstetric and Urologic Sciences, Sapienza - University, Rome, Italy
| | - Roberto Brunelli
- Department of Gynecologic, Obstetric and Urologic Sciences, Sapienza - University, Rome, Italy
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Méndez C, Soler R, Rodríguez E, Barriales R, Ochoa JP, Monserrat L. Differential diagnosis of thickened myocardium: an illustrative MRI review. Insights Imaging 2018; 9:695-707. [PMID: 30302634 PMCID: PMC6206373 DOI: 10.1007/s13244-018-0655-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/18/2018] [Accepted: 08/07/2018] [Indexed: 02/07/2023] Open
Abstract
Objectives The purpose of this article is to describe the key cardiac magnetic resonance imaging (MRI) features to differentiate hypertrophic cardiomyopathy (HCM) phenotypes from other causes of myocardial thickening that may mimic them. Conclusions Many causes of myocardial thickening may mimic different HCM phenotypes. The unique ability of cardiac MRI to facilitate tissue characterisation may help to establish the aetiology of myocardial thickening, which is essential to differentiate it from HCM phenotypes and for appropriate management. Teaching points • Many causes of myocardial thickening may mimic different HCM phenotypes. • Differential diagnosis between myocardial thickening aetiology and HCM phenotypes may be challenging. • Cardiac MRI is essential to differentiate the aetiology of myocardial thickening from HCM phenotypes.
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Affiliation(s)
- Cristina Méndez
- Radiology Department, Complexo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña, Xubias de Arriba 86, 15006, A Coruña, Spain
| | - Rafaela Soler
- Radiology Department, Complexo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña, Xubias de Arriba 86, 15006, A Coruña, Spain
| | - Esther Rodríguez
- Radiology Department, Complexo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña, Xubias de Arriba 86, 15006, A Coruña, Spain.
| | - Roberto Barriales
- Cardiology Department, Complexo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña, Xubias de Arriba, 84, 15006, A Coruña, Spain
| | - Juan Pablo Ochoa
- Cardiology Department, Complexo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña, Xubias de Arriba, 84, 15006, A Coruña, Spain
| | - Lorenzo Monserrat
- Cardiology Department, Complexo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña, Xubias de Arriba, 84, 15006, A Coruña, Spain
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Abstract
This paper provides a literature review on left ventricular noncompaction (noncompact cardiomyopathy). It details the historical aspects, epidemiology, ethology, pathophysiology, clinical features, diagnosis, treatment, and prognosis of this abnormality.
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Affiliation(s)
- O V Gaisenok
- United Hospital with Outpatient Department, Presidential Administration of the Russian Federation, Moscow, Russia
| | - P A Kurnosov
- Central State Medical Academy, Presidential Administration of the Russian Federation, Moscow, Russia
| | - S A Berns
- A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia; Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
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14
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Alonso J, López M, Garcia J, Ruiz DL, Navarro C. Left Ventricular Noncompaction Associated with Wolf-Parkinson-White Syndrome and Acute Heart Failure in Two Adult Patients. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791502200205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Left ventricular noncompaction is a relatively newly defined disorder of the endomyocardium characterized by prominent ventricular trabeculations and deep intertrabecular recesses. It is important that clinician can recognise and differentiate this condition from other forms of cardiomyopathy as treatment and prognosis may differ significantly. We report two cases of left ventricular non-compaction in the emergency department with different forms of presentations. (Hong Kong j.emerg.med. 2015;22:108-112)
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Affiliation(s)
- Jv Alonso
- Hospital Valle de los Pedroches, Department of Radiology, Pozoblanco, Córdoba, Spain
| | - Ma López
- Hospital Valle de los Pedroches, Department of Radiology, Pozoblanco, Córdoba, Spain
| | - Jp Garcia
- Hospital Valle de los Pedroches, Department of Radiology, Pozoblanco, Córdoba, Spain
| | - Dj López Ruiz
- Hospital Valle de los Pedroches, Department of Radiology, Pozoblanco, Córdoba, Spain
| | - C Navarro
- Hospital Valle de los Pedroches, Department of Radiology, Pozoblanco, Córdoba, Spain
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15
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Ronderos RE. Reply. Am J Cardiol 2017; 120:e49-e50. [PMID: 27780554 DOI: 10.1016/j.amjcard.2016.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 09/14/2016] [Indexed: 11/29/2022]
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16
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Hai T, Amador Y, Jiang L, Ju H, Yu C, Feng Y, Mahmood F. An Unusual Left Ventricular Finding in a Patient With Bicuspid Aortic Valve Stenosis. J Cardiothorac Vasc Anesth 2017; 31:2318-2319. [PMID: 28476449 DOI: 10.1053/j.jvca.2017.02.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Ting Hai
- Department of Anesthesiology, Peking University People׳s Hospital, Beijing, China; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Yannis Amador
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Anesthesia, Hospital México, Universidad de Costa Rica, San José, Costa Rica
| | - Luyang Jiang
- Department of Anesthesiology, Peking University People׳s Hospital, Beijing, China
| | - Hui Ju
- Department of Anesthesiology, Peking University People׳s Hospital, Beijing, China
| | - Chao Yu
- Department of Cardiology, Peking University People׳s Hospital, Beijing, China
| | - Yi Feng
- Department of Anesthesiology, Peking University People׳s Hospital, Beijing, China
| | - Feroze Mahmood
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
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17
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Chebrolu LH, Mehta AM, Nanda NC. Noncompaction cardiomyopathy: The role of advanced multimodality imaging techniques in diagnosis and assessment. Echocardiography 2017; 34:279-289. [DOI: 10.1111/echo.13435] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Lakshmi H. Chebrolu
- Department of Cardiology; Houston Methodist DeBakey Heart and Vascular Center; Houston TX USA
| | - Anjlee M. Mehta
- Division of Cardiology; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - Navin C. Nanda
- Division of Cardiovascular Disease; University of Alabama at Birmingham; Birmingham AL USA
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18
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Ronderos R, Avegliano G, Borelli E, Kuschnir P, Castro F, Sanchez G, Perea G, Corneli M, Zanier MM, Andres S, Aranda A, Conde D, Trivi M. Estimation of Prevalence of the Left Ventricular Noncompaction Among Adults. Am J Cardiol 2016; 118:901-905. [PMID: 27448685 DOI: 10.1016/j.amjcard.2016.06.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 06/15/2016] [Accepted: 06/15/2016] [Indexed: 10/21/2022]
Abstract
The prevalence of left ventricular noncompacted myocardium (LVNC) is not clearly defined yet. The goal of this study was to prospectively assess the prevalence of LVNC in a population of patients assessed for cardiovascular disease and to analyze the coincidence between observers using the echocardiographic criteria for diagnosis of LVNC. We included patients prospectively during a 1-year period. To analyze the concordance between different observers, we performed a blind analysis of 50 patients between 7 operators to calculate Kappa index for each criteria. The analysis of concordance for final diagnosis of LVNC was free-marginal kappa: 0.94. A total of 10,857 patients underwent echocardiography; 2,931 (27%) were normal. LVNC was found in 26 patients (prevalence = 0.24%), 16 patients were women, mean age of 52.6 years. Patients were divided into 2 groups; group A: ejection fraction (EF) <50% (n = 20) and group B: normal systolic function (n = 6). Among abnormal studies, 294 (2.7%) were dilated cardiomyopathies (DCs) Patients with LVNC and EF <50% comprised 6.8% of DC (20 of 294) and 24% (20 of 75) of patients with idiopathic DC (p <0.0001). Group A patients were older and with less presence of women (both p <0.05). In conclusion, the prevalence of LVNC in a population assessed for cardiovascular diseases is low. In contrast, it is very high in the subgroup of patients with idiopathic DC. The group of patients with LVNC and normal LVEF is younger and with a higher presence of women than those with LVNC and depressed LVEF. Coincidence between operators is very good for the identification of echocardiographic criteria.
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19
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Left Ventricular Noncompaction: Imaging Findings and Diagnostic Criteria. AJR Am J Roentgenol 2015; 204:W519-30. [DOI: 10.2214/ajr.13.12326] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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20
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Finsterer J, Zarrouk-Mahjoub S. Genetic Testing Is Not Required for Diagnosing Left Ventricular Hypertrabeculation / Non-Compaction. MAEDICA 2015; 10:69-72. [PMID: 26225156 PMCID: PMC4496773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 03/10/2015] [Indexed: 11/12/2023]
Affiliation(s)
| | - Sinda Zarrouk-Mahjoub
- Laboratory of Biochemistry, UR "Human Nutrition and Metabolic Disorders" Faculty of Medicine, Monastir, Tunisia
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21
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Gati S, Rajani R, Carr-White GS, Chambers JB. Adult Left Ventricular Noncompaction. JACC Cardiovasc Imaging 2014; 7:1266-75. [DOI: 10.1016/j.jcmg.2014.09.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 09/17/2014] [Accepted: 09/22/2014] [Indexed: 01/22/2023]
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22
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Floria M, Tinica G, Grecu M. Left ventricular non-compaction -challenges and controversies. MAEDICA 2014; 9:282-288. [PMID: 25705294 PMCID: PMC4306000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 09/24/2014] [Indexed: 06/04/2023]
Abstract
Cardiomyopathies classification is based on morphological and functional phenotypes and subcategories of familial/genetic and non-familial/non-genetic disease. The non-compaction cardiomyopathy is a rare disorder which is considered to be an unclassified cardiomyopathy according to the ESC Working Group on Myocardial and Pericardial Diseases and the World Health Organization or a primary genetically-determined cardiomyopathy according to the American Heart Association. The diagnosis of non-compaction is challenging and its nosology is debated since this morphological trait can be shared by different cardiomyopathies and non-cardiomyopathy conditions. Myocardial structure has a spectrum from normal variants to the pathological phenotype of non-compaction cardiomyopathy, which reflects the embryonic structure of the human heart due to an arrest in the compaction process during the first trimester. However, when a definite diagnosis of non-compaction is made, the diagnostic process should orient towards a genetic disease with a relatively high probability of sarcomere mutations. Non-compaction cardiomyopathy is a diagnostically challenging entity. Nowadays there are some controversies associated with this cardiomyopathy, that it worth to be discussed.
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Affiliation(s)
- Mariana Floria
- Cardiovascular Disease Institute, Iasi, Romania ; "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Grigore Tinica
- Cardiovascular Disease Institute, Iasi, Romania ; "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
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23
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Reimold SC. Reversible left ventricular trabeculations in pregnancy: is this sufficient to make the diagnosis of left ventricular noncompaction? Circulation 2014; 130:453-4. [PMID: 25006200 DOI: 10.1161/circulationaha.114.011481] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sharon C Reimold
- From the Cardiology Division, University of Texas Southwestern, Dallas.
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24
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Gerstman E, Murtaza G, Rashid ZA, Pagel PS. Left Ventricular “Masses” in a Patient With Protein S Deficiency and a Recent Myocardial Infarction: Evidence of Intraventricular Thrombi or a Benign Observation? J Cardiothorac Vasc Anesth 2014; 28:430-2. [DOI: 10.1053/j.jvca.2013.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Indexed: 12/26/2022]
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25
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Niemann M, Liu D, Hu K, Cikes M, Beer M, Herrmann S, Gaudron PD, Hillenbrand H, Voelker W, Ertl G, Weidemann F. Echocardiographic quantification of regional deformation helps to distinguish isolated left ventricular non-compaction from dilated cardiomyopathy. Eur J Heart Fail 2014; 14:155-61. [DOI: 10.1093/eurjhf/hfr164] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Markus Niemann
- Department of Internal Medicine I; University of Würzburg; D-97080 Würzburg Germany
- Comprehensive Heart Failure Center; University of Würzburg; Germany
| | - Dan Liu
- Department of Internal Medicine I; University of Würzburg; D-97080 Würzburg Germany
- Comprehensive Heart Failure Center; University of Würzburg; Germany
| | - Kai Hu
- Department of Internal Medicine I; University of Würzburg; D-97080 Würzburg Germany
| | - Maja Cikes
- Department of Cardiovascular Diseases, University Hospital Center Zagreb; University of Zagreb School of Medicine; Croatia
| | - Meinrad Beer
- Institute of Radiology, University of Wuerzburg; Germany
| | - Sebastian Herrmann
- Department of Internal Medicine I; University of Würzburg; D-97080 Würzburg Germany
- Comprehensive Heart Failure Center; University of Würzburg; Germany
| | | | - Hanns Hillenbrand
- Department of Internal Medicine I; University of Würzburg; D-97080 Würzburg Germany
| | - Wolfram Voelker
- Department of Internal Medicine I; University of Würzburg; D-97080 Würzburg Germany
- Comprehensive Heart Failure Center; University of Würzburg; Germany
| | - Georg Ertl
- Department of Internal Medicine I; University of Würzburg; D-97080 Würzburg Germany
- Comprehensive Heart Failure Center; University of Würzburg; Germany
| | - Frank Weidemann
- Department of Internal Medicine I; University of Würzburg; D-97080 Würzburg Germany
- Comprehensive Heart Failure Center; University of Würzburg; Germany
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26
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Finsterer J, Stöllberger C. Juvenile 'cryptogenic' stroke from noncompaction in a neuromuscular disease. Cardiology 2014; 127:223-6. [PMID: 24481414 DOI: 10.1159/000356555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 10/14/2013] [Indexed: 11/19/2022]
Abstract
Juvenile, 'cryptogenic' stroke from left-ventricular hypertrabeculation/noncompaction (LVHT) missed on transthoracic echocardiography (TTE) but present on transesophageal echocardiography (TEE) has not been reported before. A 31-year-old Caucasian male experienced a small acute embolic ischemic stroke in the anterior territory of the left median-cerebral artery. He had a history of epilepsy until the age of 12 years with rare seizures, headache 6 weeks prior to admission and a speech disturbance lasting 2 h. He smoked 20 cigarettes per day. An intensive diagnostic work-up including TTE did not reveal the cause of the stroke. Upon TEE, however, LVHT was found. Cardiac MRI did not reveal intraventricular thrombi. There were mild indications for a neuromuscular disorder. LVHT may be a risk factor for cardioembolic stroke. Patients with cryptogenic stroke and normal TTE should undergo TEE. Patients with LVHT should undergo neurological investigation to look for neuromuscular disorders. © 2014 S. Karger AG, Basel.
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Affiliation(s)
- Josef Finsterer
- Second Medical Department, Krankenanstalt Rudolfstiftung, Vienna, Austria
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27
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Noncompaction in a septic heart, missed on echocardiography. Int J Cardiol 2014; 171:e70-1. [DOI: 10.1016/j.ijcard.2013.11.104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 11/30/2013] [Indexed: 11/22/2022]
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Khosroshahi AG, Zanjani KS, Kocharian A, Zeinaloo A, Kiani A, Rad EM. A novel method for quantification of left ventricular noncompaction using two-dimensional echocardiography in children. IRANIAN JOURNAL OF PEDIATRICS 2013; 23:519-24. [PMID: 24800010 PMCID: PMC4006499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 05/08/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Although there are several echocardiographic criteria, there is not yet a general consensus about the diagnosis of left ventricular noncompaction. The current criteria are mostly based on the areas with maximal noncompaction in the heart. The echocardiographer may miss this maximal point leading to a misdiagnosis. Accordingly, we suggested a new method to measure the percentage of myocardial noncompaction using two-dimensional echocardiography. METHODS In this study, the new method was examined on 4 noncompaction and 26 dilated cardiomyopathies, and 25 normal subjects. The percentage of noncompaction was measured at 3 levels (apical, papillary muscle and mitral valve) and averaged. FINDINGS The mean percentages of myocardial noncompaction were 3.59±2.27, 8.86±5.52 and 34.7±26.1 in the control, dilated cardiomyopathy and noncompaction groups, respectively. A value of 17% or greater could distinguish left ventricular noncompaction from dilated cardiomyopathy with 92% specificity and 100% sensitivity and from normal subjects with 100% specificity and sensitivity. This percentage had a statistically significant association with noncompacted to compacted myocardial thickness ratio (P<0.001). CONCLUSION This method showed good correlations with the existing echocardiographic and magnetic resonance criteria. However, it is not dependent on finding the area of maximal involvement. Being comparable to magnetic resonance imaging in accuracy, it is easier to perform and more available.
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Affiliation(s)
| | - Keyhan Sayadpour Zanjani
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author:Address: Division of Pediatric Cardiology, Children's Medical Center, No. 62, Dr Gharib St., Tehran, Iran. E-mail:
| | - Armen Kocharian
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
| | - Aliakbar Zeinaloo
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolrazagh Kiani
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
| | - Elaheh Malakan Rad
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
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Sousa O, Silva G, Sampaio F, Oliveira M, Gonçalves H, Primo J, Ribeiro J, Fonseca C, Albuquerque A, Simões L, Gama V. Isolated left ventricular non-compaction: A single-center experience. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2013. [DOI: 10.1016/j.repce.2013.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Sousa O, Silva G, Sampaio F, Oliveira M, Gonçalves H, Primo J, Ribeiro J, Fonseca C, Albuquerque A, Simões L, Gama V. Não compactação isolada do ventrículo esquerdo: experiência de um centro. Rev Port Cardiol 2013; 32:229-38. [DOI: 10.1016/j.repc.2012.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 06/05/2012] [Accepted: 06/18/2012] [Indexed: 10/27/2022] Open
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Şimşek Z, Açar G, Akçakoyun M, Esen Ö, Emiroğlu Y, Esen AM. Left ventricular noncompaction in a patient with multiminicore disease. J Cardiovasc Med (Hagerstown) 2012; 13:660-2. [DOI: 10.2459/jcm.0b013e32833cdcd0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Left ventricular noncompaction: a proposal of new diagnostic criteria by multidetector computed tomography. J Cardiovasc Comput Tomogr 2012; 6:346-54. [PMID: 22981859 DOI: 10.1016/j.jcct.2012.07.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Revised: 05/13/2012] [Accepted: 07/30/2012] [Indexed: 12/23/2022]
Abstract
BACKGROUND Left ventricular noncompaction (LVNC) is a cardiomyopathy characterized by a noncompacted myocardial layer in the left ventricle, primarily diagnosed by echocardiographic and magnetic resonance criteria. Multidetector computed tomography (MDCT) is an imaging method that has been increasingly used in cardiac evaluation. However, tomographic criteria to diagnose LVNC have not been determined. OBJECTIVES We assessed the structural characteristics of LVNC with MDCT and proposed tomographic criteria that may differentiate LVNC from healthy subjects and patients with other cardiomyopathies that might be associated with increased myocardial trabeculation. METHODS Between March 2007 and June 2009 we studied 10 consecutive patients with LVNC diagnosed by echocardiogram and/or magnetic resonance imaging who underwent electrocardiogram-gated coronary CT angiography. We evaluated the ratio of noncompacted to compacted myocardium (NC/C ratio) in end diastole in each of the 17 segments established by the American Heart Association (excluding the apex). The results were compared with 9 healthy subjects, 14 patients with hypertrophic cardiomyopathy, and 17 patients with dilated cardiomyopathy to determine the cutoff that would distinguish patients with LVNC. RESULTS When considering involvement of more than 1 segment, the NC/C ratio of 2.2 distinguished pathologic noncompaction, with sensitivity and specificity of 100% and 95%, respectively. In addition, the involvement of ≥2 segments allows the distinction of all patients with LVNC from other cardiomyopathies and from healthy subjects. CONCLUSIONS LVNC can be accurately diagnosed with MDCT when using a cutoff NC/C ratio of 2.2 at end diastole involving ≥2 segments.
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Hypertrophic cardiomyopathy or non-compaction? How the first impression can be wrong. Int J Cardiol 2012; 158:e53-4. [DOI: 10.1016/j.ijcard.2011.10.110] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 10/19/2011] [Indexed: 11/20/2022]
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Finsterer J, Stöllberger C. Apical noncompaction in metabolic myopathy may be missed on echocardiography but visible on cardiac MRI or misinterpreted as apical hypokinesia. Int J Cardiol 2012; 160:e15-7. [PMID: 22227253 DOI: 10.1016/j.ijcard.2011.12.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 12/17/2011] [Indexed: 11/16/2022]
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Cisneros S, Duarte R, Fernandez-Perez GC, Castellon D, Calatayud J, Lecumberri I, Larrazabal E, Ruiz BI. Left ventricular apical diseases. Insights Imaging 2011; 2:471-482. [PMID: 22347968 PMCID: PMC3259385 DOI: 10.1007/s13244-011-0091-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 01/15/2011] [Accepted: 04/01/2011] [Indexed: 12/15/2022] Open
Abstract
There are many disorders that may involve the left ventricular (LV) apex; however, they are sometimes difficult to differentiate. In this setting cardiac imaging methods can provide the clue to obtaining the diagnosis. The purpose of this review is to illustrate the spectrum of diseases that most frequently affect the apex of the LV including Tako-Tsubo cardiomyopathy, LV aneurysms and pseudoaneurysms, apical diverticula, apical ventricular remodelling, apical hypertrophic cardiomyopathy, LV non-compaction, arrhythmogenic right ventricular dysplasia with LV involvement and LV false tendons, with an emphasis on the diagnostic criteria and imaging features.
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Complete atrioventricular block and reversible systolic dysfunction in left ventricular hypertrabeculation/non-compaction with metabolic myopathy. Cardiol Young 2011; 21:229-32. [PMID: 21138615 DOI: 10.1017/s1047951110001666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A 32-year-old female patient presented with cardiac failure because of systolic dysfunction. Five years before, a DDD pacemaker had been implanted because of complete atrioventricular block. Echocardiographic examination disclosed left ventricular hypertrabeculation/non-compaction. Because of sinus tachycardia, ivabradine was started and the patient's left ventricular function returned to normal within 4 months. Recurrent creatine-kinase elevation and reduced nicotinamide adenine dinucleotide staining on muscle biopsy suggested metabolic myopathy.
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Stollberger C, Finsterer J. A diagnostic dilemma in non-compaction, resulting in near expulsion from the football world cup. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2010; 12:E8. [DOI: 10.1093/ejechocard/jeq110] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Engberding R, Stöllberger C, Ong P, Yelbuz TM, Gerecke BJ, Breithardt G. Isolated non-compaction cardiomyopathy. DEUTSCHES ARZTEBLATT INTERNATIONAL 2010; 107:206-13. [PMID: 20386670 PMCID: PMC2853150 DOI: 10.3238/arztebl.2010.0206] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Accepted: 07/21/2009] [Indexed: 01/28/2023]
Abstract
BACKGROUND Isolated non-compaction cardiomyopathy (NCCM) was first described in 1984. This disorder, a primary genetic cardiomyopathy, is now attracting increased attention. METHOD The current state of the epidemiology, pathogenesis, pathophysiology, clinical features, diagnosis, treatment, and prognosis of NCCM are discussed on the basis of a review of selected literature as well as the authors' personal experience. RESULTS The pathogenesis of NCCM is thought to involve a genetically determined disturbance of the myocardial compaction process during fetal endomyocardial morphogenesis. It is not accompanied by any other cardiac anomalies. Echocardiography is the diagnostic method of choice. The diagnosis is based on the following echocardiographic criteria: the presence of at least 4 prominent trabeculations and deep intertrabecular recesses, blood flow from the ventricular cavity into the intertrabecular recesses, and a typical bilaminar structure of the affected portion of the left ventricular myocardium. NCCM can also be diagnosed with magnetic resonance imaging of the heart. The clinical severity of NCCM is variable; its manifestations include heart failure, thromboembolic events, and arrhythmias. The treatment is symptom-based. Patients with symptomatic NCCM have a poor prognosis. CONCLUSION NCCM is a type of cardiomyopathy that was first described 25 years ago. Its molecular genetic basis is not yet fully clear, and the same is true of its diagnosis, treatment, and prognosis. Further study of these matters is needed.
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Affiliation(s)
- Rolf Engberding
- Medizinische Klinik, Lehrkrankenhaus der MHH, Klinikum der Stadt Wolfsburg, Sauerbruchstr. 7, 38440 Wolfsburg, Germany.
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Left ventricular hypertrabeculation/noncompaction in a patient with peripartum cardiomyopathy. Int J Cardiol 2010; 139:e18-20. [DOI: 10.1016/j.ijcard.2008.08.025] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Accepted: 08/10/2008] [Indexed: 11/18/2022]
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Abstract
According to the World Health Organization classification of cardiomyopathies, left ventricular noncompaction is still an unclassified cardiomyopathy. In 2006, the American Heart Association classified this entity as a primary cardiomyopathy of genetic origin. In 2008, the European Society of Cardiology updated the classification scheme similar to the World Health Organization classification. At present, there is no consensus on the diagnostic criteria, and diagnosis is based on the morphologic features identified by cardiac imaging studies or at autopsy. Due to lack of standardization of the diagnostic criteria and little awareness of this condition among clinicians, the true prevalence of this disease is not clear. There is no specific therapy for this condition. However, it seems prognosis is much better than initially reported. The current status of diagnosis, prognosis, and management of isolated noncompaction in adults is discussed in this review.
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Affiliation(s)
- Radha J Sarma
- ABIM, Internal Medicine and Cardiovascular Diseases, University of Southern California, Keck School of Medicine, Division of Cardiovascular Medicine, Los Angeles, CA 90033, USA.
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Stöllberger C, Steger C, Finsterer J. Myopathy, left ventricular noncompaction, and tetralogy of fallot. Clin Cardiol 2009; 32:E46-8. [PMID: 19816976 PMCID: PMC6653198 DOI: 10.1002/clc.20366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2007] [Revised: 12/06/2007] [Indexed: 11/11/2022] Open
Abstract
Left ventricular hypertrabeculation, also termed noncompaction (LVHT) is a cardiac abnormality characterized by excessive trabeculations of the left ventricular cavity. LVHT may be associated with extracardiac abnormalities, most frequently neuromuscular disorders (NMDs). LVHT associated with tetralogy of Fallot (ToF), so far, has been reported in 2 cases, but no indication for the presence of NMDs are given.We present a 47-year old female who underwent 2 cardiac surgeries because of ToF, and was admitted because of heart failure. She was diagnosed with echocardiographic LVHT. A myopathy was diagnosed by biopsy.
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Abstract
This is a report of a child who died at 20 months from what was clinically thought to be cardiomyopathy of unknown etiology. Barth syndrome, an X-linked mitochondrial cardioskeletal myopathy, was diagnosed by genetic testing at autopsy. Barth syndrome presents in infancy or childhood with cardiomyopathy, hypotonia, growth delays, and cyclic neutropenia. Other associated laboratory findings can include hypocholesterolemia, relative monocytosis, low prealbumin, low plasma carnitine, and lactic acidosis. The classic echocardiogram finding is left ventricular noncompaction, although not always present. Until recently, the most reliable biochemical finding has been 3-methylglutaconic aciduria. However, quantitative analysis must be specifically requested for results to be reliable. Recently, a confirmatory tetralinoleoyl cardiolipin high-pressure liquid chromotography-tandem mass spectrometry blood test has become available. Genetic testing is also confirmatory and details the underlying mutation. Diagnosis is often missed or delayed and early diagnosis improves survival. The purpose of this case report is to encourage physicians to include Barth syndrome in the differential for cardiomyopathy of uncertain etiology in males, especially in the presence of growth delays, hypotonia, neutropenia, and/or family history of pediatric male death of unknown etiology.
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Affiliation(s)
- Robert T Sweeney
- Department of Pathology and Laboratory Medicine, University of Kentucky College of Medicine, Lexington, KY, USA.
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Ahmed I, Phan TT, Lipkin GW, Frenneaux M. Ventricular noncompaction in a female patient with nephropathic cystinosis: a case report. J Med Case Rep 2009; 3:31. [PMID: 19178729 PMCID: PMC2649139 DOI: 10.1186/1752-1947-3-31] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Accepted: 01/29/2009] [Indexed: 01/25/2023] Open
Abstract
Introduction We report an unusual and interesting case of a 24-year-old woman with nephropathic cystinosis in association with concomitant isolated noncompaction of the left ventricle. Left ventricular noncompaction usually presents with reduced exercise tolerance as a consequence of ventricular dysfunction, the result of embolus or with palpitations and syncope due to arrhythmia. There is no specific treatment directed at isolated noncompaction. Treatment is focused on the cause of presentation, with medication aimed at improving ventricular dysfunction, as well as treating and preventing thrombosis and arrhythmia. Case presentation Our patient presented with an episode of decompensated heart failure. Trans-thoracic echocardiography demonstrated excessive trabeculation with inter-trabecular recesses in the left ventricle typical of noncompaction of the left ventricle. The patient's admission was complicated by a cardiac arrest precipitated by ventricular tachycardia for which she subsequently underwent implantation of an automatic implantable cardioverter defibrillator. Conclusion This is, as far as we know, the first case report of the co-existence of nephropathic cystinosis and isolated noncompaction of the left ventricle. It highlights the importance of being vigilant to the diagnosis of left ventricular noncompaction.
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Affiliation(s)
- Ibrar Ahmed
- Department of Cardiovascular Medicine, Medical School, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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Rehfeldt KH, Mauermann WJ, Bower TC, Click RL. The Diagnosis of Left Ventricular Hypertrabeculation/Noncompaction by Intraoperative Transesophageal Echocardiography. J Cardiothorac Vasc Anesth 2008; 22:858-60. [DOI: 10.1053/j.jvca.2008.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Indexed: 11/11/2022]
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Wahbi K, Meune C, Bassez G, Laforêt P, Vignaux O, Marmursztejn J, Bécane HM, Eymard B, Duboc D. Left ventricular non-compaction in a patient with myotonic dystrophy type 2. Neuromuscul Disord 2008; 18:331-3. [DOI: 10.1016/j.nmd.2007.11.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Revised: 10/29/2007] [Accepted: 11/28/2007] [Indexed: 11/15/2022]
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