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Cavarretta E, D'Ascenzi F, Bianco M, Castelletti S, Cavigli L, Cecchi F, D'Andrea A, De Luca A, Di Salvo G, Nistri S, Palamà Z, Palmieri V, Ricci F, Sinagra G, Zorzi A, Biffi A, Pelliccia A, Romano S, Dello Russo A, Zeppilli P, Patrizi G, Sciarra L. The role of echocardiography in sports cardiology: An expert opinion statement of the Italian Society of Sports Cardiology (SIC sport). Int J Cardiol 2024; 410:132230. [PMID: 38852859 DOI: 10.1016/j.ijcard.2024.132230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 05/09/2024] [Accepted: 06/03/2024] [Indexed: 06/11/2024]
Abstract
Transthoracic echocardiography (TTE) is routinely required during pre-participation screening in the presence of symptoms, family history of sudden cardiac death or cardiomyopathies <40-year-old, murmurs, abnormal ECG findings or in the follow-up of athletes with a history of cardiovascular disease (CVD). TTE is a cost-effective first-line imaging modality to evaluate the cardiac remodeling due to long-term, intense training, previously known as the athlete's heart, and to rule out the presence of conditions at risk of sudden cardiac death, including cardiomyopathies, coronary artery anomalies, congenital, aortic and heart valve diseases. Moreover, TTE is useful for distinguishing physiological cardiac adaptations during intense exercise from pathological behavior due to an underlying CVD. In this expert opinion statement endorsed by the Italian Society of Sports Cardiology, we discussed common clinical scenarios where a TTE is required and conditions falling in the grey zone between the athlete's heart and underlying cardiomyopathies or other CVD. In addition, we propose a minimum dataset that should be included in the report for the most common indications of TTE in sports cardiology clinical practice.
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Affiliation(s)
- Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Advanced Cardiovascular Therapies Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, Sports Cardiology and Rehab Unit, University of Siena, Siena, Italy
| | - Massimiliano Bianco
- Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, Rome, Italy; Unit of Sports Medicine, Faculty of Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Silvia Castelletti
- Department of Cardiology, Istituto Auxologico Italiano IRCCS, Piazzale Brescia 20, 20149 Milan, Italy
| | - Luna Cavigli
- Department of Medical Biotechnologies, Sports Cardiology and Rehab Unit, University of Siena, Siena, Italy
| | - Franco Cecchi
- Department of Cardiology, Istituto Auxologico Italiano IRCCS, Piazzale Brescia 20, 20149 Milan, Italy
| | - Antonello D'Andrea
- Department of Cardiology and Intensive Coronary Care, Umberto I Hospital, 84014 Nocera Inferiore, Italy
| | - Antonio De Luca
- Cardiothoracovascular Department, Division of Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste, 34149 Trieste, Italy
| | - Giovanni Di Salvo
- Department of Woman and Child Health, Paediatric Cardiology and Congenital Heart Disease, University of Padova, 35128 Padova, Italy
| | - Stefano Nistri
- CMSR Veneto Medica, 36077 Altavilla Vicentina, VI, Italy
| | - Zefferino Palamà
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, piazzale Salvatore Tommasi 1, 67100 Coppito, Italy; Electrophysiology Unit, Casa di Cura "Villa Verde", Taranto, Italy
| | - Vincenzo Palmieri
- Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, Rome, Italy; Unit of Sports Medicine, Faculty of Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, G.d'Annunzio University of Chieti-Pescara, Via Luigi Polacchi, 11, 66100 Chieti, Italy; Heart Department, SS. Annunziata Hospital, ASL 2 Abruzzo, 66100 Chieti, Italy; Department of Clinical Sciences, Lund University, Jan Waldenströms gata 35, 214 28 Malmö, Sweden
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Division of Cardiology, Azienda Sanitaria Universitaria Giuliano Isontina and University of Trieste, 34149 Trieste, Italy
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Alessandro Biffi
- Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, RomeMaranello, MO, Italy
| | - Antonio Pelliccia
- Institute of Sport Medicine and Science, National Italian Olympic Committee, Rome, Italy
| | - Silvio Romano
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, piazzale Salvatore Tommasi 1, 67100 Coppito, Italy
| | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy
| | - Paolo Zeppilli
- Sports Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, Rome, Italy; Unit of Sports Medicine, Faculty of Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy.
| | - Giampiero Patrizi
- Department of Cardiology, B. Ramazzini Hospital, Ausl Modena, Carpi, Italy
| | - Luigi Sciarra
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, piazzale Salvatore Tommasi 1, 67100 Coppito, Italy
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Llerena-Velastegui J, Velastegui-Zurita S, Santander-Fuentes C, Dominguez-Gavilanes D, Roa-Guerra A, Jesus ACFSD, Coelho PM, Carrasco-Perez P, Calderon-Lopez C, Benitez-Gutierrez D. Advances and challenges in the diagnosis and management of left ventricular noncompaction in adults: A literature review. Curr Probl Cardiol 2024; 49:102571. [PMID: 38608914 DOI: 10.1016/j.cpcardiol.2024.102571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
In the realm of cardiovascular health, isolated left ventricular noncompaction (LVNC) stands out for its distinct morphological features and the clinical challenges it presents, particularly in adults. This literature review explores the intricacies of LVNC, aiming to unravel its epidemiological spread, diagnostic hurdles, and therapeutic strategies. Despite technological advancements in cardiac imaging that have improved the recognition of LVNC, a significant gap persists alongside a fragmented understanding of its pathogenesis. The studies scrutinized reveal a broad spectrum of prevalence rates influenced by diverse diagnostic tools and demographic variables. This variation underscores the complexity of accurately identifying LVNC and the resultant implications for clinical management. The review succinctly addresses the need for precise guidelines to navigate the diagnosis of LVNC and outlines the imperative for tailored clinical management approaches that cater to the wide array of patient presentations, from asymptomatic cases to those with severe cardiac dysfunction. By highlighting the critical gaps in current literature-namely the absence of standardized diagnostic criteria and a comprehensive pathogenic model-the review sets the stage for future research directions. These endeavors are essential for enhancing diagnostic accuracy, refining management protocols, and ultimately improving patient outcomes in this complex subset of cardiomyopathy, thus contributing significantly to the advancement of cardiovascular medicine.
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Affiliation(s)
- Jordan Llerena-Velastegui
- Pontifical Catholic University of Ecuador, Medical School, Quito, Ecuador; Center for Health Research in Latin America (CISeAL), Research Center, Quito, Ecuador.
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3
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Azhar W, Singh G, Saveeta F, Singh D, Ratnani T, Singla D, Kachhadia MP, Goyal N, Puri P. Left Ventricular Non-compaction and Associated Cardiomyopathy Presenting With Cardiac Failure: A Case Report. Cureus 2024; 16:e59265. [PMID: 38813285 PMCID: PMC11134517 DOI: 10.7759/cureus.59265] [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] [Accepted: 04/29/2024] [Indexed: 05/31/2024] Open
Abstract
The characteristic structural anomaly of the heart in the left ventricular non-compaction (LVNC) is identified with a prominent layer of the trabecular meshwork, thin compacted myocardium, and intertrabecular recesses within the depths of the left ventricle. Despite growing clinical recognition, the prevalence of LVNC in adults and the full clinical spectrum remain poorly explored. The disease shows heterogeneous phenotypes from an asymptomatic presentation to severe cardiac complications like cardiac failure, arrhythmias, and thromboembolic events. Current diagnostic practices for LVNC lack standardized guidelines, making patient management difficult. We here report a case of an adult patient who presented with features of congestive cardiac failure and on detailed imaging with echocardiogram and magnetic resonance imaging (MRI) was diagnosed to have LVNC. We here also emphasize that there is a great need for refined diagnostic criteria that include genetic, clinical, and imaging data. Cases of LVNC with full-blown phenotypic expression should be used for diagnostic criteria.
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Affiliation(s)
- Waqas Azhar
- Internal Medicine, Memorial Medical Center, Springfield, USA
- Internal Medicine, Saint John's Hospital, Springfield, USA
- Internal Medicine, Southern Illinois University School of Medicine, Springfield, USA
- Hospital Medicine, Springfield Clinic, Springfield, USA
| | - Gurjot Singh
- Internal Medicine, Maharaj Sawan Singh Charitable Hospital, Beas, IND
| | - Fnu Saveeta
- Internal Medicine, People's University of Medical and Health Sciences, Nawabshah, PAK
| | - Didar Singh
- Internal Medicine, Memorial Medical Center, Springfield, USA
| | - Tanya Ratnani
- Internal Medicine, Government Medical College, Bilaspur, Bilaspur, IND
| | - Deepak Singla
- Internal Medicine, Adesh Institute of Medical Science and Research, Bathinda, IND
| | | | - Ninia Goyal
- Internal Medicine, Chirayu Medical College and Hospital, Bhopal, IND
| | - Piyush Puri
- Internal Medicine, Adesh Institute of Medical Science and Research, Bathinda, IND
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Casavecchia G, Gravina M, Mautone F, Pesolo M, Mangini F, Macarini L, Brunetti ND. Left Ventricle Noncompaction Phenotype: Cause or Consequence? J Cardiovasc Echogr 2024; 34:25-28. [PMID: 38818316 PMCID: PMC11135822 DOI: 10.4103/jcecho.jcecho_30_22] [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: 05/09/2022] [Revised: 12/30/2023] [Accepted: 02/06/2024] [Indexed: 06/01/2024] Open
Abstract
Left ventricular noncompaction (LVNC) is commonly described as a congenital cardiomyopathy characterized by prominent myocardial trabeculae and deep intertrabecular recesses extending in the left ventricular chamber. Clinical presentation can differ considerably from asymptomatic individuals to those presenting with heart failure and other serious complications. Diagnosis is usually made by two-dimensional transthoracic echocardiography or cardiac magnetic resonance. Moreover, even if strain parameters are significantly reduced in patients with LVNC, they are not routinely investigated. Here, we report the case of a previously symptomless patient admitted to the hospital for pulmonary edema. Two-dimensional transthoracic echocardiography showed severe valvular heart disease and left ventricle pronounced trabeculation and remodeling, although speckle tracking echocardiography (STE) demonstrated only mild strain reduction. We, therefore, explore the possibility that STE may be useful to differentiate LVNC cardiomyopathy from LVNC phenotype due to severe remodeling.
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Affiliation(s)
- Grazia Casavecchia
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Matteo Gravina
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Francesco Mautone
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Maurizio Pesolo
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Francesco Mangini
- ICU/Cardiology Unit, “Camberlingo” Hospital, Francavilla Fontana, Brindisi, Italy
| | - Luca Macarini
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
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Petersen SE, Jensen B, Aung N, Friedrich MG, McMahon CJ, Mohiddin SA, Pignatelli RH, Ricci F, Anderson RH, Bluemke DA. Excessive Trabeculation of the Left Ventricle: JACC: Cardiovascular Imaging Expert Panel Paper. JACC Cardiovasc Imaging 2023; 16:408-425. [PMID: 36764891 PMCID: PMC9988693 DOI: 10.1016/j.jcmg.2022.12.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 12/07/2022] [Accepted: 12/22/2022] [Indexed: 02/10/2023]
Abstract
Excessive trabeculation, often referred to as "noncompacted" myocardium, has been described at all ages, from the fetus to the adult. Current evidence for myocardial development, however, does not support the formation of compact myocardium from noncompacted myocardium, nor the arrest of this process to result in so-called noncompaction. Excessive trabeculation is frequently observed by imaging studies in healthy individuals, as well as in association with pregnancy, athletic activity, and with cardiac diseases of inherited, acquired, developmental, or congenital origins. Adults with incidentally noted excessive trabeculation frequently require no further follow-up based on trabecular pattern alone. Patients with cardiomyopathy and excessive trabeculation are managed by cardiovascular symptoms rather than the trabecular pattern. To date, the prognostic role of excessive trabeculation in adults has not been shown to be independent of other myocardial disease. In neonates and children with excessive trabeculation and normal or abnormal function, clinical caution seems warranted because of the reported association with genetic and neuromuscular disorders. This report summarizes the evidence concerning the etiology, pathophysiology, and clinical relevance of excessive trabeculation. Gaps in current knowledge of the clinical relevance of excessive trabeculation are indicated, with priorities suggested for future research and improved diagnosis in adults and children.
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Affiliation(s)
- Steffen E Petersen
- William Harvey Research Institute, National Institute for Health and Care Research Barts Biomedical Research Centre, Queen Mary University London, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service Trust, London, United Kingdom.
| | - Bjarke Jensen
- Department of Medical Biology, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Nay Aung
- William Harvey Research Institute, National Institute for Health and Care Research Barts Biomedical Research Centre, Queen Mary University London, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service Trust, London, United Kingdom
| | - Matthias G Friedrich
- Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada; Department of Diagnostic Radiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Colin J McMahon
- Department of Paediatric Cardiology, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Saidi A Mohiddin
- William Harvey Research Institute, National Institute for Health and Care Research Barts Biomedical Research Centre, Queen Mary University London, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, Barts Health National Health Service Trust, London, United Kingdom
| | - Ricardo H Pignatelli
- Department of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging, and Clinical Sciences, "G.d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Robert H Anderson
- Biosciences Institute, Newcastle University, Newcastle, United Kingdom
| | - David A Bluemke
- School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA
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The use of 2-D speckle tracking echocardiography in assessing adolescent athletes with left ventricular hypertrabeculation meeting the criteria for left ventricular non-compaction cardiomyopathy. Int J Cardiol 2023; 371:500-507. [PMID: 36216087 DOI: 10.1016/j.ijcard.2022.09.076] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/23/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Current echocardiographic criteria cannot accurately differentiate exercise induced left ventricular (LV) hypertrabeculation in athletes from LV non-compaction cardiomyopathy (LVNC). This study aims to evaluate the role of speckle tracking echocardiography (STE) in characterising LV myocardial mechanics in healthy adolescent athletes with and without LVNC echocardiographic criteria. METHODS Adolescent athletes evaluated at three sports academies between 2014 and 2019 were considered for this observational study. Those meeting the Jenni criteria for LVNC (end-systolic non-compacted/compacted myocardium ratio > 2 in any short axis segment) were considered LVNC+ and the rest LVNC-. Peak systolic LV longitudinal strain (Sl), circumferential strain (Sc), rotation (Rot), corresponding strain rates (SRl/c) and segmental values were calculated and compared using a non-inferiority approach. RESULTS A total of 417 participants were included, mean age 14.5 ± 1.7 years, of which 6.5% were LVNC+ (n = 27). None of the athletes showed any additional LVNC clinical criteria. All average Sl, SRl Sc, SRc and Rot values were no worse in the LVNC+ group compared to LVNC- (p values range 0.0003-0.06), apart from apical SRc (p = 0.2). All 54 segmental measurements (Sl/Sc SRl/SRc and Rot) had numerically comparable means in both LVNC+ and LVNC-, of which 69% were also statistically non-inferior. CONCLUSIONS Among healthy adolescent athletes, 6.5% met the echocardiographic criteria for LVNC, but showed normal LV STE parameters, in contrast to available data on paediatric LVNC describing abnormal myocardial function. STE could better characterise the myocardial mechanics of athletes with LV hypertrabeculation, thus allowing the transition from structural to functional LVNC diagnosis, especially in suspected physiological remodelling.
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Finsterer J, Stöllberger C, Laccone F. Noncompaction and the novel variant c.425A>T in TPM1. Acta Cardiol 2022; 77:758-759. [PMID: 34309477 DOI: 10.1080/00015385.2021.1954746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Josef Finsterer
- Messerli Institute, Klinik Landstrasse, Postfach 20, 1180 Vienna, Austria
| | - Claudia Stöllberger
- 2nd Medical Department with Cardiology and Intensive Care Medicine, Klinik Landstrasse, Vienna, Austria
| | - Franco Laccone
- Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
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Hirono K, Ichida F. Left ventricular noncompaction: a disorder with genotypic and phenotypic heterogeneity-a narrative review. Cardiovasc Diagn Ther 2022; 12:495-515. [PMID: 36033229 PMCID: PMC9412206 DOI: 10.21037/cdt-22-198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/21/2022] [Indexed: 01/10/2023]
Abstract
Background and Objective Left ventricular noncompaction (LVNC) is a cardiomyopathy characterized by excessive trabecular formation and deep recesses in the ventricular wall, with a bilaminar structure consisting of an endocardial noncompaction layer and an epicardial compacted layer. Although genetic variants have been reported in patients with LVNC, understanding of LVNC and its pathogenesis has not yet been fully elucidated. We addressed the latest findings on genes reported to be associated with LVNC morphogenesis and possible pathologies to understand the diverse spectrum between genotype and phenotype in LVNC. Also, the latest findings and issues related to the diagnosis of LVNC were summarized. Methods This article is written as a commentary narrative review and will provide an update on the current literature and available data on common forms of LVNC published in the past 30 years in English through to May 2022 using PubMed. Key Content and Findings Familial forms of LVNC are frequent, and autosomal dominant mode of inheritance has been predominantly observed. Several of the candidate causative genes are also mutated in other cardiomyopathies, suggesting a possible shared molecular and/or cellular etiology. The most common gene functions were sarcomere function whereas genes in mice LVNC models were involved in heart development. Echocardiography and cardiac magnetic resonance imaging (CMR) are useful for diagnosis although there are no unified criteria due to overdiagnosis of imaging, poor consistency between techniques, and lack of association between trabecular severity and adverse clinical outcomes. Conclusions This review reflects the current lack of clarity regarding the pathogenesis and significance of LVNC and showed the complexity of imaging diagnostic criteria, interpretation of the role of LVNC as a cause, and uncertainty regarding the specific genetic basis of LVNC.
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Affiliation(s)
- Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, International University of Health and Welfare, Tokyo, Japan
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Lukas Laws J, Lancaster MC, Ben Shoemaker M, Stevenson WG, Hung RR, Wells Q, Marshall Brinkley D, Hughes S, Anderson K, Roden D, Stevenson LW. Arrhythmias as Presentation of Genetic Cardiomyopathy. Circ Res 2022; 130:1698-1722. [PMID: 35617362 PMCID: PMC9205615 DOI: 10.1161/circresaha.122.319835] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
There is increasing evidence regarding the prevalence of genetic cardiomyopathies, for which arrhythmias may be the first presentation. Ventricular and atrial arrhythmias presenting in the absence of known myocardial disease are often labelled as idiopathic, or lone. While ventricular arrhythmias are well-recognized as presentation for arrhythmogenic cardiomyopathy in the right ventricle, the scope of arrhythmogenic cardiomyopathy has broadened to include those with dominant left ventricular involvement, usually with a phenotype of dilated cardiomyopathy. In addition, careful evaluation for genetic cardiomyopathy is also warranted for patients presenting with frequent premature ventricular contractions, conduction system disease, and early onset atrial fibrillation, in which most detected genes are in the cardiomyopathy panels. Sudden death can occur early in the course of these genetic cardiomyopathies, for which risk is not adequately tracked by left ventricular ejection fraction. Only a few of the cardiomyopathy genotypes implicated in early sudden death are recognized in current indications for implantable cardioverter defibrillators which otherwise rely upon a left ventricular ejection fraction ≤0.35 in dilated cardiomyopathy. The genetic diagnoses impact other aspects of clinical management such as exercise prescription and pharmacological therapy of arrhythmias, and new therapies are coming into clinical investigation for specific genetic cardiomyopathies. The expansion of available genetic information and implications raises new challenges for genetic counseling, particularly with the family member who has no evidence of a cardiomyopathy phenotype and may face a potentially negative impact of a genetic diagnosis. Discussions of risk for both probands and relatives need to be tailored to their numeric literacy during shared decision-making. For patients presenting with arrhythmias or cardiomyopathy, extension of genetic testing and its implications will enable cascade screening, intervention to change the trajectory for specific genotype-phenotype profiles, and enable further development and evaluation of emerging targeted therapies.
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Affiliation(s)
- J Lukas Laws
- Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN
| | - Megan C Lancaster
- Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN
| | - M Ben Shoemaker
- Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN
| | - William G Stevenson
- Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN
| | - Rebecca R Hung
- Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN
| | - Quinn Wells
- Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN
| | - D Marshall Brinkley
- Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN
| | - Sean Hughes
- Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN
| | - Katherine Anderson
- Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN
| | - Dan Roden
- Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN
| | - Lynne W Stevenson
- Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN
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Kiss AR, Gregor Z, Furák Á, Szabó LE, Dohy Z, Merkely B, Vágó H, Szűcs A. Age- and Sex-Specific Characteristics of Right Ventricular Compacted and Non-compacted Myocardium by Cardiac Magnetic Resonance. Front Cardiovasc Med 2021; 8:781393. [PMID: 34950717 PMCID: PMC8688768 DOI: 10.3389/fcvm.2021.781393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/15/2021] [Indexed: 12/02/2022] Open
Abstract
The age and sex-specific characteristics of right ventricular compacted (RV-CMi) and RV-trabeculated myocardial mass (RV-TMi) and the determinants of RV myocardium are less well-studied; however, in different conditions, these might provide additional diagnostic information. We aimed to describe the age- and sex-specific characteristics of RV-CMi, RV-TMi, and RV volumetric and functional parameters and investigate the determinants of RV myocardial mass with cardiac magnetic resonance (CMR). Two hundred healthy Caucasian volunteers free of known cardiovascular or systemic diseases were prospectively enrolled in this study. Four different age groups were established with equal numbers of males and females: Group A (n = 50, 20-29 years, mean age: 24.3 ± 3.2 years), Group B (n = 50, 30-39 years, mean age: 33.6 ± 2.6 years), Group C (n = 50, 40-49 years, mean age: 44.7 ± 2.7 years), and Group D (n = 50, ≥50 years, mean age: 55.1 ± 3.9 years). Left ventricular (LV) and RV volumetric, functional, CMi, and TMi values were measured with a threshold-based post-processing CMR method. The volumetric parameters, RV-CMi, and RV-TMi values were larger, and the ejection fraction (EF) was lower in males. The RV-CMi did not correlate with age in either of the sexes, while the RV-TMi decreased with age in females but remained stable in males. The RV-TMi and RV-CMi correlated positively with RV volumetric parameters, the LV-CMi, the LV-TMi, and each other in both sexes. LV-TMi, LV-CMi, RV end-systolic volume, and sex were independent predictors of RV-TMi. Understanding the characteristics of RV-trabeculated and RV-compacted myocardium might have additive value in diagnosing different conditions with RV hypertrophy or hypertrabeculation.
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Affiliation(s)
- Anna Réka Kiss
- Heart and Vascular Center of Semmelweis University, Budapest, Hungary
| | - Zsófia Gregor
- Heart and Vascular Center of Semmelweis University, Budapest, Hungary
| | - Ádám Furák
- Heart and Vascular Center of Semmelweis University, Budapest, Hungary
| | | | - Zsófia Dohy
- Heart and Vascular Center of Semmelweis University, Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center of Semmelweis University, Budapest, Hungary
| | - Hajnalka Vágó
- Heart and Vascular Center of Semmelweis University, Budapest, Hungary
| | - Andrea Szűcs
- Heart and Vascular Center of Semmelweis University, Budapest, Hungary
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Lin Y, Huang J, Zhu Z, Zhang Z, Xian J, Yang Z, Qin T, Chen L, Huang J, Huang Y, Wu Q, Hu Z, Lin X, Xu G. Overlap phenotypes of the left ventricular noncompaction and hypertrophic cardiomyopathy with complex arrhythmias and heart failure induced by the novel truncated DSC2 mutation. Orphanet J Rare Dis 2021; 16:496. [PMID: 34819141 PMCID: PMC8611834 DOI: 10.1186/s13023-021-02112-9] [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: 08/06/2021] [Accepted: 11/06/2021] [Indexed: 12/18/2022] Open
Abstract
Background The left ventricular noncompaction cardiomyopathy (LVNC) is a rare subtype of cardiomyopathy associated with a high risk of heart failure (HF), thromboembolism, arrhythmia, and sudden cardiac death. Methods The proband with overlap phenotypes of LVNC and hypertrophic cardiomyopathy (HCM) complicates atrial fibrillation (AF), ventricular tachycardia (VT), and HF due to the diffuse myocardial lesion, which were diagnosed by electrocardiogram, echocardiogram and cardiac magnetic resonance imaging. Peripheral blood was collected from the proband and his relatives. DNA was extracted from the peripheral blood of proband for high-throughput target capture sequencing. The Sanger sequence verified the variants. The protein was extracted from the skin of the proband and healthy volunteer. The expression difference of desmocollin2 was detected by Western blot. Results The novel heterozygous truncated mutation (p.K47Rfs*2) of the DSC2 gene encoding an important component of desmosomes was detected by targeted capture sequencing. The western blots showed that the expressing level of functional desmocollin2 protein (~ 94kd) was lower in the proband than that in the healthy volunteer, indicating that DSC2 p.K47Rfs*2 obviously reduced the functional desmocollin2 protein expression in the proband. Conclusion The heterozygous DSC2 p.K47Rfs*2 remarkably and abnormally reduced the functional desmocollin2 expression, which may potentially induce the overlap phenotypes of LVNC and HCM, complicating AF, VT, and HF.
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Affiliation(s)
- Yubi Lin
- The Center of Cardiovascular Diseases, The Department of Cardiology, Radiology and Ultrasonography, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China
| | - Jiana Huang
- The Center of Cardiovascular Diseases, The Department of Cardiology, Radiology and Ultrasonography, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China.,Reproductive Center, The Six Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Zhiling Zhu
- The Center of Cardiovascular Diseases, The Department of Cardiology, Radiology and Ultrasonography, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China
| | - Zuoquan Zhang
- The Center of Cardiovascular Diseases, The Department of Cardiology, Radiology and Ultrasonography, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China
| | - Jianzhong Xian
- The Center of Cardiovascular Diseases, The Department of Cardiology, Radiology and Ultrasonography, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China
| | - Zhe Yang
- The Center of Cardiovascular Diseases, The Department of Cardiology, Radiology and Ultrasonography, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China
| | - Tingfeng Qin
- Department of Physiology, The School of Medicine of Jinan University, Guangzhou, 510000, China
| | - Linxi Chen
- Department of Physiology, The School of Medicine of Jinan University, Guangzhou, 510000, China
| | - Jingmin Huang
- Department of Physiology, The School of Medicine of Jinan University, Guangzhou, 510000, China
| | - Yin Huang
- The Center of Cardiovascular Diseases, The Department of Cardiology, Radiology and Ultrasonography, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China
| | - Qiaoyun Wu
- The Center of Cardiovascular Diseases, The Department of Cardiology, Radiology and Ultrasonography, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China
| | - Zhenyu Hu
- The Center of Cardiovascular Diseases, The Department of Cardiology, Radiology and Ultrasonography, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117593, Singapore
| | - Xiufang Lin
- The Center of Cardiovascular Diseases, The Department of Cardiology, Radiology and Ultrasonography, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China.
| | - Geyang Xu
- Department of Physiology, The School of Medicine of Jinan University, Guangzhou, 510000, China.
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12
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Contreras-Briceño F, Herrera S, Vega-Adauy J, Salinas M, Ocaranza MP, Jalil JE, Mandiola J, García L, Chiong M, Castro PF, Lavandero S, Gabrielli L. Circulating Vascular Cell Adhesion Molecule-1 (sVCAM-1) Is Associated With Left Atrial Remodeling in Long-Distance Runners. Front Cardiovasc Med 2021; 8:737285. [PMID: 34790706 PMCID: PMC8591189 DOI: 10.3389/fcvm.2021.737285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/11/2021] [Indexed: 01/26/2023] Open
Abstract
Introduction: An increased risk of atrial fibrillation (AF) has been demonstrated in high-performance athletes. Soluble vascular adhesion molecule-1 (sVCAM-1), a biomarker involved in inflammation and cardiac remodeling, is associated with the development of AF in the general population. However, the relationship between sVCAM-1 and left atrial (LA) remodeling has been poorly investigated in long-distance runners (LDR). Aim: To determine the association between LA remodeling and sVCAM-1 levels in LDR during the training period before a marathon race. Methods: Thirty-six healthy male LDR (37.0 ± 5.3 years; 174.0 ± 7.0 height; BMI: 23.8 ± 2.8; V°O2-peak: 56.5 ± 7.3 mL·kg−1·min−1) were evaluated in this single-blind and cross-sectional study. The LDR were separated into two groups according to previous training levels: high-training (HT) (n = 18) ≥100 km·week−1 and low-training (LT) (n = 18) ≥70 and <100 km·week−1. Also, 18 healthy non-active subjects were included as a control group (CTR). In all participants, transthoracic echocardiography was performed. sVCAM-1 blood levels were measured baseline and immediately finished the marathon race in LDR. Results: HT showed increased basal levels of sVCAM-1 (651 ± 350 vs. 440 ± 98 ng·mL−1 CTR, p = 0.002; and vs. 533 ± 133 ng·mL−1 LT; p = 0.003) and a post-marathon increase (ΔsVCAM-1) (651 ± 350 to 905 ± 373 ng·mL−1; p = 0.002), that did not occur in LT (533 ± 133 to 651 ± 138 ng·mL−1; p = 0.117). In LDR was a moderate correlation between LA volume and sVCAM-1 level (rho = 0.510; p = 0.001). Conclusions: In male long-distance runners, sVCAM-1 levels are directly associated with LA remodeling. Also, the training level is associated with basal sVCAM-1 levels and changes after an intense and prolonged exercise (42.2 km). Whether sVCAM-1 levels predict the risk of AF in runners remains to be established.
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Affiliation(s)
- Felipe Contreras-Briceño
- Division of Cardiovascular Diseases, Advanced Center for Chronic Diseases (ACCDiS), Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Laboratory of Exercise Physiology, Department Health of Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sebastián Herrera
- Division of Cardiovascular Diseases, Advanced Center for Chronic Diseases (ACCDiS), Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Julian Vega-Adauy
- Division of Cardiovascular Diseases, Advanced Center for Chronic Diseases (ACCDiS), Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Manuel Salinas
- Division of Cardiovascular Diseases, Advanced Center for Chronic Diseases (ACCDiS), Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - María Paz Ocaranza
- Division of Cardiovascular Diseases, Advanced Center for Chronic Diseases (ACCDiS), Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge E Jalil
- Division of Cardiovascular Diseases, Advanced Center for Chronic Diseases (ACCDiS), Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Mandiola
- Division of Cardiovascular Diseases, Advanced Center for Chronic Diseases (ACCDiS), Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Lorena García
- Advanced Center for Chronic Diseases (ACCDiS) and CEMC, Faculty of Chemical and Pharmaceutical Sciences & Faculty of Medicine, University of Chile, Santiago, Chile
| | - Mario Chiong
- Advanced Center for Chronic Diseases (ACCDiS) and CEMC, Faculty of Chemical and Pharmaceutical Sciences & Faculty of Medicine, University of Chile, Santiago, Chile
| | - Pablo F Castro
- Division of Cardiovascular Diseases, Advanced Center for Chronic Diseases (ACCDiS), Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sergio Lavandero
- Advanced Center for Chronic Diseases (ACCDiS) and CEMC, Faculty of Chemical and Pharmaceutical Sciences & Faculty of Medicine, University of Chile, Santiago, Chile.,Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Luigi Gabrielli
- Division of Cardiovascular Diseases, Advanced Center for Chronic Diseases (ACCDiS), Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Laboratory of Exercise Physiology, Department Health of Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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13
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de la Chica JA, Gómez-Talavera S, García-Ruiz JM, García-Lunar I, Oliva B, Fernández-Alvira JM, López-Melgar B, Sánchez-González J, de la Pompa JL, Mendiguren JM, Martínez de Vega V, Fernández-Ortiz A, Sanz J, Fernández-Friera L, Ibáñez B, Fuster V. Association Between Left Ventricular Noncompaction and Vigorous Physical Activity. J Am Coll Cardiol 2021; 76:1723-1733. [PMID: 33032733 DOI: 10.1016/j.jacc.2020.08.030] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/21/2020] [Accepted: 08/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Left ventricular (LV) hypertrabeculation fulfilling noncompaction cardiomyopathy criteria has been detected in athletes. However, the association between LV noncompaction (LVNC) phenotype and vigorous physical activity (VPA) in the general population is disputed. OBJECTIVES The aim of this study was to assess the relationship between LVNC phenotype on cardiac magnetic resonance (CMR) imaging and accelerometer-measured physical activity (PA) in a cohort of middle-aged nonathlete participants in the PESA (Progression of Early Subclinical Atherosclerosis) study. METHODS In PESA participants (n = 4,184 subjects free of cardiovascular disease), PA was measured by waist-secured accelerometers. CMR was performed in 705 subjects (mean age 48 ± 4 years, 16% women). VPA was recorded as total minutes per week. The study population was divided into 6 groups: no VPA and 5 sex-specific quintiles of VPA rate (Q1 to Q5). The Petersen criterion for LVNC was evaluated in all subjects undergoing CMR. For participants meeting this criterion (noncompacted-to-compacted ratio ≥2.3), 3 more restrictive LVNC criteria were also evaluated (Jacquier, Grothoff, and Stacey). RESULTS LVNC phenotype prevalence according to the Petersen criterion was significantly higher among participants in the highest VPA quintile (Q5 = 30.5%) than in participants with no VPA (14.2%). The Jacquier and Grothoff criteria were also more frequently fulfilled in participants in the highest VPA quintile (Jacquier Q5 = 27.4% vs. no VPA = 12.8% and Grothoff Q5 = 15.8% vs. no VPA = 7.1%). The prevalence of the systolic Stacey LVNC criterion was low (3.6%) and did not differ significantly between no VPA and Q5. CONCLUSIONS In a community-based study, VPA was associated with a higher prevalence of CMR-detected LVNC phenotype according to diverse established criteria. The association between VPA and LVNC phenotype was independent of LV volumes. According to these data, vigorous recreational PA should be considered as a possible but not uncommon determinant of LV hypertrabeculation in asymptomatic subjects.
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Affiliation(s)
- Jose A de la Chica
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; Hospital Quironsalud, Malaga, Spain
| | - Sandra Gómez-Talavera
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; IIS-Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; CIBER Enfermedades Cardiovasculares, Madrid, Spain
| | - Jose M García-Ruiz
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; CIBER Enfermedades Cardiovasculares, Madrid, Spain; Hospital de Cabueñes, Gijón, Spain
| | - Ines García-Lunar
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; CIBER Enfermedades Cardiovasculares, Madrid, Spain; Hospital Universitario Quirón, Madrid, Spain
| | - Belén Oliva
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
| | - Juan M Fernández-Alvira
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; CIBER Enfermedades Cardiovasculares, Madrid, Spain; Hospitales HM, Madrid, Spain
| | - Beatriz López-Melgar
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; CIBER Enfermedades Cardiovasculares, Madrid, Spain; Hospitales HM, Madrid, Spain
| | | | - José L de la Pompa
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; CIBER Enfermedades Cardiovasculares, Madrid, Spain; Intercellular Signalling in Cardiovascular Development & Disease Laboratory, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
| | | | - Vicente Martínez de Vega
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; Hospital Universitario Quirón, Madrid, Spain
| | - Antonio Fernández-Ortiz
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; CIBER Enfermedades Cardiovasculares, Madrid, Spain; Hospital Clínico San Carlos, Madrid, Spain
| | - Javier Sanz
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; Icahn School of Medicine at Mount Sinai, New York, New York
| | - Leticia Fernández-Friera
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; CIBER Enfermedades Cardiovasculares, Madrid, Spain; Hospitales HM, Madrid, Spain.
| | - Borja Ibáñez
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; IIS-Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; CIBER Enfermedades Cardiovasculares, Madrid, Spain.
| | - Valentín Fuster
- Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; Icahn School of Medicine at Mount Sinai, New York, New York
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14
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Femia G, Semsarian C, Ross SB, Celermajer D, Puranik R. Left Ventricular Non-Compaction: Review of the Current Diagnostic Challenges and Consequences in Athletes. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E697. [PMID: 33327510 PMCID: PMC7764920 DOI: 10.3390/medicina56120697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/06/2020] [Accepted: 12/10/2020] [Indexed: 11/16/2022]
Abstract
Left ventricular non-compaction (LVNC) is a complex clinical condition with no diagnostic gold standard. At present, there is trepidation about the accuracy of the diagnosis, the correlation to clinical outcomes and the long-term medical management. This article reviews the current imaging criteria, the limitations of echocardiography and cardiac magnetic resonance and the consequences of LV hypertrabeculation in athletes.
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Affiliation(s)
- Giuseppe Femia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (C.S.); (S.B.R.); (D.C.); (R.P.)
| | - Christopher Semsarian
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (C.S.); (S.B.R.); (D.C.); (R.P.)
- Agnes Ginges Centre for Molecular Cardiology Centenary Institute, Camperdown 2050, Australia
| | - Samantha B. Ross
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (C.S.); (S.B.R.); (D.C.); (R.P.)
- Department of Cardiology, Royal Prince Alfred Hospital, Camperdown 2050, Australia
| | - David Celermajer
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (C.S.); (S.B.R.); (D.C.); (R.P.)
- Department of Cardiology, Royal Prince Alfred Hospital, Camperdown 2050, Australia
| | - Rajesh Puranik
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (C.S.); (S.B.R.); (D.C.); (R.P.)
- Department of Cardiology, Royal Prince Alfred Hospital, Camperdown 2050, Australia
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15
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Martinez HR, Miller E, Mead R, Osher J, Almasri M, Parent JJ. Biventricular noncompaction cardiomyopathy with severe dilated phenotype in a family with a novel MYH7 gene variant. PROGRESS IN PEDIATRIC CARDIOLOGY 2020. [DOI: 10.1016/j.ppedcard.2020.101205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Affiliation(s)
- Andrew D'Silva
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK .,School of Cardiovascular Medicine & Sciences, King's College London, London, UK
| | - Bjarke Jensen
- Department of Medical Biology, University of Amsterdam, Amsterdam, The Netherlands
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17
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Clinical outcomes in patients with left ventricle trabeculation or noncompaction. Int J Cardiovasc Imaging 2020; 37:467-477. [PMID: 32901347 DOI: 10.1007/s10554-020-02013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022]
Abstract
Trabeculation exhibits highly varied presentations, whereas noncompaction (NC) is a specific disease entity based arithmetically on wall thickness. We aimed to evaluate the clinical implications of trabeculation and its relevance to outcomes. A total of 296 patients (age 63 ± 12 years; 64% men) with trabeculation who underwent echocardiography were retrospectively identified between January 2011 and December 2012. Analyses were conducted on distinguished trabeculation which was divided into NC (maximum noncompacted/compacted ratio ≥ 2.0) or hypertrabeculation (HT) (ratio < 2.0). We evaluated features of trabeculation and explored cardiovascular (CV) outcome events (coronary revascularization, hospitalization for worsening heart failure (HF), stroke, nonsustained ventricular tachycardia (VT), implantation of an implantable cardioverter defibrillator (ICD), and CV death). Over a mean of 4.2 years, CV outcome events occurred in 122 (41%) patients who were older and exhibited an increased frequency of diabetes mellitus, stroke, implantation of ICD, HF and dilated cardiomyopathy. The frequencies of NC or HT, the trabeculation ratio and its manifestation were similar among patients with and without events. NC/HT with concomitant apical hypocontractility and worsening systolic function were univariable predictors of adverse events. On multivariable analysis, concomitant apical hypocontractility on NC/HT remained significant (hazard ratio 8.94, 95% confidence interval 2.9-27.2, p < 0.001) together with old age, HF and increased E/e' ratio. NC/HT with concomitant apical hypocontractility provided clues about the current medical illness and aided in risk stratification.
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18
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Maestrini V, Torlasco C, Hughes R, Moon JC. Cardiovascular Magnetic Resonance and Sport Cardiology: a Growing Role in Clinical Dilemmas. J Cardiovasc Transl Res 2020; 13:296-305. [PMID: 32436168 PMCID: PMC7360536 DOI: 10.1007/s12265-020-10022-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/05/2020] [Indexed: 12/14/2022]
Abstract
Exercise training induces morphological and functional cardiovascular adaptation known as the "athlete's heart" with changes including dilatation, hypertrophy, and increased stroke volume. These changes may overlap with pathological appearances. Distinguishing athletic cardiac remodelling from cardiomyopathy is important and is a frequent medical dilemma. Cardiac magnetic resonance (CMR) has a role in clinical care as it can refine discrimination of health from a disease where ECG and echocardiography alone have left or generated uncertainty. CMR can more precisely assess cardiac structure and function as well as characterise the myocardium detecting key changes including myocardial scar and diffuse fibrosis. In this review, we will review the role of CMR in sports cardiology.
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Affiliation(s)
- Viviana Maestrini
- Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Camilla Torlasco
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Department of Cardiovascular, Neural and Metabolic Sciences, S.Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Rebecca Hughes
- Institute of Cardiovascular Science, University College London, Gower Street, London, UK
- Barts Heart Centre, Advanced Cardiac Imaging and The Inherited Cardiovascular Diseases Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK
| | - James C Moon
- Institute of Cardiovascular Science, University College London, Gower Street, London, UK.
- Barts Heart Centre, Advanced Cardiac Imaging and The Inherited Cardiovascular Diseases Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.
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