Keywords:
Cardiac, MR, Diagnostic procedure, Dilatation
Authors:
O. Larina, E. A. Mershina, V. Sinitsyn, M. Kharlap, R. Miasnikov; Moscow/RU
Results
In the studied group of patients with LV NC CMP incidence of HF was 83%,
rhythm disturbances - 60%.
LV was dilated (mean end-diastolic size was 66,3±8,5mm,
LV EDV index 133,0±81,3ml/m2),
its global contractile function was severely decreased (mean EF=31±14%).
NC myocardium was located in the apical and/or mid-ventricular segments of the LV.
The mean number of segments with NC (NSNC) per patient was 6±2 and the mean trabeculation index was 4,0±1,5.
Significant correlations between LV EDV index and NC LV MM,
MM index were found (r=0.83,
p<0.05 and r=0.82,
p<0.05,
corresp).
NSNC correlated with LVEF (r=0.82,
p<0.05),
LV end-diastolic size - with trabeculation index (r=0.78,
p<0.05).
Echocardiography was used to be the diagnostic procedure of choice.
Nevetheless,
at the present time cardiovascular magnetic resonance imaging (CMRI) has been reported as the main modality to characterise patients with LV NC CMP as it provides both a high spatial resolution and a good contrast between trabeculation and blood pool [1].
One major advantage of CMRI is the three-dimensional approach,
which allows for imaging of the entire volume of the heart with lower investigator dependency and without limitations caused by a patient’s constitution [4].
The main differential diagnoses include apical form of hypertrophic cardiomyopathy and dilatation cardiomyopathy.
In CMRI,
a diastolic ratio of more than 2.3 between the non-compact and compact layers is required for the diagnosis of the non-compacted myocardium.
Treatment management of the LV NC CMP focuses on the 3 major clinical manifestations: heart failure,
arrhythmias,
and systemic embolic events.
Standard medical therapy for systolic and diastolic ventricular dysfunction is warranted [4].
The early and precise diagnosis is mandatory to rule out other underlying diagnoses and to allow a timely start of standard heart failure and anticoagulation therapy which may prevent further complications,
such as embolic events.